Happy Teacher’s Day 2021, Teacher’s day best wishes

In India, Teachers’ Day is celebrated on September 5th to mark the birthday of former President, politician, scholar, philosopher and Bharat Ratna recipient, Dr Sarvepalli Radhakrishnan, who was born on the same day in 1888.

Teacher’s Day wishes

According to me, every person is your teacher from whom you learn something in your life. Who shows the right direction to your life and supports you at every turn and identifies good and bad does not matter whether he is really a professional teacher or not so Happy teacher’s day all the lovely teachers in the world.

Happy teacher’s day

Dr. MIRZA WAQAR BEG, HE IS THE BEST TEACHER IN THE WORLD, He is a very kind person and has a very kind heart. Wherever I am today, the credit goes to you only. You have guided me in every path and gave me right suggestions. Whatever you have done for me, thank you would be a very short word. 

Teacher’s day is not just a day for fun and change of roles. It is also a day to remember how much of hard work and time goes in, before a teacher walks into that classroom and teaches you that chapter. It is a day for showing gratitude towards the person who has patiently heard you out when you asked the same question a hundred times. It is also a day to thank the person who guided you in matters more than academic. 

So always respect your teacher


Nutrition Week 2021, Theme, “Feeding smart right from start”. 

National Nutrition Week 2021: The purpose behind celebrating is to spread awareness about good nutrition, and health. Initiatives have been taken up by the government focussing on nutrition, good food, healthy body, mind, and lifestyle.

2021 Theme of National Nutrition Week

The theme for National Nutrition Week 2021 is “Feeding smart right from start”. 

A balanced diet nourishes the body from top to toe, and National Nutrition Week was first marked in 1975 by American Dietetic Association.

In India, the National Nutrition Week is celebrates every year from September 1 to September 7 to raise public awareness about nutrition and healthy eating habits. The week is observed to make people understand the importance of nutritional and adaptive eating habits so that they can maintain a healthy lifestyle.

Importance of Nutrition

For the last two years, we have come to understand that how important a good diet is for our health.Corona has taught all the people the importance of good food and only when we eat nutritious food, our body will have the ability to fight diseases.

Nutritious food

What is Nutrition?

Our food is made up of essential, natural substances called nutrients. Human body needs over 50 nutrients on a daily basis to stay healthy. Nutrients are categorized as macronutrients including carbohydrates, proteins, fat; and micronutrients such as vitamins, minerals and trace elements.

Macronutrients are needed in large quantities and are referred to as the energy yielding components of diet, i.e they breakdown into simpler compounds to provide energy.

Micronutrients are needed in small quantities, but are very essential to keep us healthy. They do not yield energy but have a protective role and are needed to enhance immunity.

All nutrients work together to maintain overall health. Each of these nutrients is required in a specific amount by the body. The deficiency and excess of nutrients can be harmful, leading to a variety of complex diseases.

Carbohydrates, proteins and fats comprise macronutrients and contribute to energy intake by humans as Carbohydrates.


The main source of energy in the Indian diet. Carbohydrates contribute to taste, texture and bulk to the diet.

They are essential for digestion and assimilation of other foods. Lack of carbohydrates (less than 30%) in the diet may produce ketosis, loss of weight and breakdown of proteins.


Protein is the second most abundant substance in the body after water. They are required for the growth and synthesis of tissues in the body; formation of digestive juices, hormones, plasma proteins enzymes, vitamins, hemoglobin; as buffers to maintain acid-base equilibrium in the body; and as an alternate source of energy for the body. Proteins are made of amino acids. Amino acids that can be synthesized in the body are called non-essential amino acids, while essential amino acids require to be supplied in the diet.

Essential amino acids include leucine, isoleucine, lysine, methionine, phenylalanine, threonine, tryptophan and valine. Histidine and arginine are essential during infancy because the rate of their synthesis is inadequate for sustaining growth.


Fats function as structural elements of the cell membranes, act as vehicle for absorption and transport of fat-soluble vitamins (A, D, E and K) and are precursors of prostaglandins and hormones. Fats are made of fatty acids and dietary fats are mixture of largely triglycerides, small proportion of phospholipids and cholesterol.

Requirements: Fats are major source of energy in diet, In normally growing children, about 25-30% of energy intake should be derived from fat which includes 10-15% invisible fat. However, in malnourished children, up to 45% of calories can be safely provided from fat.

Invisible fat: Fat present naturally in our food but cannot be seen and separated from food such as milk and milk products, egg and meat, nuts contain good amount, while cereals, pulses, vegetables and fruits contain negligible amount.

Visible fat: Fat which is used for cooking or added while cooking such as edible vegetable oils and ghee. To provide a healthy balance of visible fat, daily diet should provide <7% saturated fat, 10% polyunsaturated fat and rest 13% should be derived from monounsaturated fats. A minimum of 3% energy should be derived from linoleic acid and 0.3% from linolenic acid.

There is no single oil/fat with the ideal composition; it is recommended to use blend of two or more vegetable oils.


Energy needs of children are computed keeping in mind the increase in body size, high metabolic rate that regulates body temperature and maintains high level of activities, and marked developmental changes in organ function and composition.

All follow my these articles

vitamin and minerals.

Balance Diet. What should we eat According to ICMR?

Blood pressure measurement technique, Procedure of BP

Blood pressure is one of the four vital signs of our body. The four vital signs are heart rate, breathing rate, temperature, and fourth is blood pressure. These four signs indicate that everything is fine in our body or not.

Now a days almost one person of every single family suffering from hypertension and hypotension. In this type of patients, they always need to check their blood pressure everyday.

Digital & Manual B.P. Machine Which is batter.

Two types of Blood pressure machines are available in the market, first is Mercury sphygmomanometer with appropriate cuff used for manual method, and second is Digital BP machine which is use to checked blood pressure it is easy to use.

But as we are medical professionals, we mainly preferred blood pressure should be checked by manual BP machine. Blood pressure with manual BP machine checked  in a better way and it’s readings are also considered more accurate.

That’s why I thought why not teach everyone to check blood pressure through this article today.

B.P. Machine and it’s Part

Blood pressure machine also know as (in medicine line) sphygmomanometer. 

Blood pressure
Blood pressure machine

1- Rubber Pump or inflation bulb is a hand pump that was used to pump air into the ‘inflatable cuff’. Pressure controller connected with Rubber Pump. 

2 Inflatable cuff is wrapped around the upper arm and is connected to an apparatus that records pressure.

3- Rubber tube- The BP instrument has two rubber tube. One is attached from Mercury to inflatable cuff another is attached Rubber Pump to inflatable cuff.

4- Manometer. It is used to measure the air pressure in mmHg.

5-Valve. It is use as a deflation valve to control the cuff. Play a vital role in getting an accurate measurement.

6-Scale or Gauge- This the scale where the reading is appear of the blood pressure.

A blood pressure reading includes two numbers that indicate the pressure inside the arteries as the blood flows through the body.

Procedure to check blood pressure

Preferred procedure of Blood pressure should be measured after a period of adequate rest (3-5 min), twice on each occasion in the right arm in seated position. 

Raise your arm to heart level. Elevate your arm so that when you bend your elbow, your elbow is parallel to your heart. You can check you blood pressure on both arm.

1-Wrap the cuff around the upper arm. We have to tie the cuff one to two inches above the cubital fossa. (The cubital fossa is a triangular-shaped depression over the anterior aspect of the elbow joint).Make sure the cuff is snug, but not too tight. 

Blood pressure
Cuff placement

Don’t place the cuff over clothing.

2- Firstly you have to place your index finger and middle finger on brachial artery and feel puls if you feel puls then place the stethoscope is over the brachial artery pulse, below the bottom edge of the cuff. 

Blood pressure
Stethoscope placement

3- Close the airflow valve on the bulb by turning the screw clockwise. Inflate (air into the cuff) the cuff by squeezing the bulb with your right hand.

4- Keep inflating the cuff Keep pumping until the needle on the gauge reaches around 180mmHg. Above your expected systolic pressure.

5-Keeping your eyes on the gauge, slowly release the pressure in the cuff by opening the airflow valve anticlockwise. 

6-Listen carefully for the first pulse beat. As soon as you hear it, note the reading on the gauge.

This reading is your systolic pressure (the force of the blood against the artery walls as your heart beats). It is the higher number of the two blood pressure readings.

when blood pressure is written down, it appears at the top.

The clinical name for the puls sounds your hear is “Korotkoff sounds.”That is called upper blood pressure.

Continue to slowly deflate the cuff.

7-Listen carefully until the sound disappears. As soon as you can no longer hear your pulse, note the reading on the gauge.

This reading is your diastolic pressure. (pressure in your arteries when your heart rests between beats).

It is the lower number of the two blood pressure readings, and when blood pressure is written down, it appears at the bottom.

What is Blood pressure readings means?

Once you have recorded blood pressure, it is important to know about reading means

Normal blood pressure: Systolic blood pressure should be 120mmHg and diastolic blood pressure should be 80 mmHg. If your blood pressure is 125/85mmHg doesn’t mean your blood pressure is High there is no specific range in medical field.

Stage 1 Hypertension: Systolic number between 140mmHg and 159mmHg, diastolic number between 90mmHg and 99mmHg.

Stage 2 Hypertension: Systolic number higher than 160mmHg and diastolic number higher than 100mmHg.

Hypertensive Crisis: Systolic number higher than 180mmHg and diastolic number higher than 110mmHg. mmHg(milimeter of Mercury) is the Unit of Blood pressure measurement 

Hope this article will help you to measurement of Blood pressure.

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Rh incompatibility, Negative blood group in females

Rh incompatibility is the major cause of infants mortality. It can be preventable if it is timely diagnosed. Rh negative blood is found only 15% of total population in the world. In this population some are women and some men.

If Rh negative blood in male then it is not a problematic condition. If this Rh negative blood is in female, then it is a matter of concern.

There is still a lack of awareness in our society even today people do not consider it necessary to teach girls due to this reason, girls do not get complete information about anything.  It’s mainly because of lack of awareness about this disease. Every girl must know her blood group  if she has negative blood group then she must be told about the complications she might encounter during pregnancy and delivery.

These all deaths are preventable provided timely interventions are done. Awareness campaign is also very important in ruler area because many women aren’t educated and they have no any idea about blood groups because of this reason many babies aborted in two or three month they don’t understand why this is happening.

I feel that Rh Incompatibility should be taught in schools. Every girl and boy should know that if there blood group is Rh negative then what should they expect after marriage and at the time of conceiving.

Let’s know about

Rh Incompatibility.

Rh incompatibility is a condition which develops when there is a difference in Rh blood type between that of the pregnant mother (Rh negative) and that of the fetus (Rh positive).

Rh Incompatibility  is a condition in which the mother’s blood group is negative and the baby blood group is positive. If father’s blood group is positive and the mother’s is negative, it is very likely that the baby’s blood group may be positive. If child and mother both blood group are negative there is no any risk in this type of pregnancy.

If the unborn child’s blood group is positive and the mother’s is negative, then it is a matter of concern. If this is your first child and you have never had an abortion or DNC,  so this child will have no any risk.

Now it comes that if you have ever had an abortion or miscarriage before this, then you have to be aware of Rh disease.

What is Rh disease or          Rh incompatibility?

Rh disease is a dangerous kind of anemia. Anemia is when a person doesn’t have enough healthy red blood cells to carry oxygen to the rest of the body.

Rh incompatibility
Rh incompatibility

Rh disease (also called Rh incompatibility) happens when your blood is Rh-negative and your baby’s blood is Rh-positive. This means your blood and your baby’s blood are incompatible, so it’s not safe for them to mix together.

If they do mix, your body makes Rh antibodies that may go from your body through the placenta into your baby’s body, where they attack and destroy her red blood cells. When your baby’s positive blood is mixed with your negative blood, your body will start making antibodies against it. Because we all know that the defense mechanism of our body is to prepare an army against any external thing immediately and eliminates that extraneous thing.

Similarly, when a child’s positive blood mixes with the mother’s blood, the mother’s immune system prepares antibodies against it. The child has nutrition and oxygen through the umbilical cord from mother’s placenta ,then along with the mother’s blood, the antibodies made in it also start mixing in the baby’s blood and these antibodies break down the child’s  blood cells, which causes anemia in the child. If you have Rh antibodies, you’re called Rh sensitisation.

What is Rh Sensitisation?

Rh is an antigen. The full name for this antigen is Rhesus factor.

If a pregnant woman with Rh-negative blood is pregnant with a baby (fetus) with Rh-positive blood, Rh sensitisation may occur. The baby may have Rh-positive blood if the father has Rh-positive blood. Rh sensitisation happens when the baby’s blood mixes with the mother’s blood during pregnancy or delivery.

This causes the mother’s immune system to make antibodies against the baby’s red blood cells in future pregnancies. This antibody response is called Rh sensitisation and, depending on when it happens, can destroy the red blood cells of the baby before or after it is born.

If sensitisation happens, a fetus can develop mild to severe problems (called Rh disease or erythroblastosis fetalis). In rare cases, if Rh disease is not treated, the fetus may die.

Indirect Coombs test (ICT)?

An indirect Coombs test can be used to determine whether there are antibodies to the Rh factor in the mother’s blood. 

A normal or negative result means that the mother has not developed antibodies against the fetus’s blood. A negative Coombs test indicates that the fetus is not presently in danger from problems relating to Rh incompatibility.

An abnormal or positive result means that the mother has developed antibodies to the fetal red blood cells and is sensitized. However, a positive Coombs test only indicates that an Rh-positive fetus has a possibility of being harmed. A positive test cannot indicate the amount of fetal harm.

is Rh Incompatibility be preventable?

Yes every girls should know their blood group so that she knows about every problem that comes and she can prepare herself for it. When she become a mother for the first time, tell her doctor in advance about her blood group, due to lack of awareness many unborn child may die so awareness of Rh negative blood group is very importance in both male,  female.

Treatment during pregnancy can protect your baby and future pregnancies.

If you’re Rh-negative and your baby is Rh positive, she may be at risk for Rh disease. It can cause serious problems for your baby, including death.

Firstborn babies usually aren’t affected by Rh disease. But if it’s not treated, Rh disease can cause serious harm in later pregnancies. when you conceive your second pregnancy after abortion or miscarriage timely visit your doctor and confirm it your blood has any antibody against Rh positive blood group in previous pregnancy.

In this condition your gynecologist suggest you Anti D injection after conceive your pregnancy this injection help to neutralize the antibodies.

You can find out if you’re Rh-negative with a blood test.

If both you and your baby’s father are Rh-positive: Your baby’s blood is Rh positive, and there’s no risk of Rh disease in your baby.

If both you and your baby’s father are Rh-negative: Your baby’s blood is Rh negative, and there’s no risk of Rh disease for your baby.

If you’re Rh negative and your baby’s father is Rh-positive: Your baby’s blood may be Rh-positive. Your baby is at risk for Rh disease and needs to be checked closely.

Effect of Rh Disease in babies.

If Rh incompatibility  is not treated on time, it can lead to the death of child.

Rh incompatibility causes a large number of red blood cells in the fetus to be destroyed. This is also know as HEMOLYTIC DISEASE OF NEWBORN. This may leads to problems including total body swelling. If the hemolytic anemia is severe, the baby may get a blood transfusion through the umbilical cord. In this condition treatment should be done from the fetal medicine department only.

one of the best Fetal medicine department in SGPGI Lucknow Uttar Pradesh. DR. Mandakni Pradhan is the head of fetal medicine department.

The department has performed more than 300 intrauterine blood transfusion and the smallest fetus to received blood transfusion at 18 weeks with Hb of 0.9 gm/dl. This is one of the earliest intrauterine transfusion reported in world literature. So if you live in nearest of Lucknow and you have Rh negative blood group so consult to Dr. Mandakni Pradhan.

Rh incompatibility
Intrauterine blood transfusion

Mother immune system attacks unborn baby’s red blood cell. This causes sever anemia, and large amount of fluid build up in the baby’s tissue and organs and developed Edema (sever Swelling) in an unborn baby this condition called HYDROPS FITALIS.

Rh Negative
Hydrops Fitalis

Rh incompatibility

Jaundice can make your baby’s eyes and skin look yellow. A baby has jaundice when his liver isn’t fully developed or isn’t working. If jaundice is severe and isn’t treated, a baby can develop a kind of brain damage called KERNICTERUS.

Treatment of Rh Incompatibility

If you haven’t developed Rh antibodies, your doctor can give you a shot of Rh immunoglobulin called Rh anti (D) immune globulin (brand name RhoGAM).

Rh anti D can prevent your body from producing Rh antibodies so your baby and future pregnancies won’t get Rh disease.

Anti D doesn’t work if your body has already started making Rh antibodies in a previous pregnancy. This is why it’s really important to get prenatal care as early as possible in every pregnancy.

If you’re RH-negative, you get RhoGAM:

At about 28 weeks of pregnancy

Within 72 hours after the birth if your baby is Rh-positive or if baby’s Rh is unknown.

Rh disease can be prevented in your baby if you get treatment at the right time.  

You may also receive Rh immunoglobulin if the risk of blood transfer between you and the baby is high for example, if you have has a miscarriage, ectopic pregnancy, or bleeding during pregnancy.

Try that the delivery of a woman with a negative blood group should be done in such an institution where the doctor has complete information about it and the child can get a good treatment immediately

Delivery done only in such an institution where is NICU facility is available because there is a lot of chances in the negative blood group that premature delivery can happen and immediate need to shift the baby in NICU.

At the time of delivery, the doctor should take a blood sample from the cord of the child.So that he can know the blood group and hemoglobin of the child.

If the child has low hemoglobin, then blood exchange and blood transfusion may also have to be done in it.

Phototherapy and IVIG (intravenous Immunoglobulin) therapy is the supportive treatment most widely use in  Rh disease.

Phototherapy in new born

So every girl should know about her blood group who are dying before delivery because Rh incompatibility. Whenever a woman of negative blood group conceives, then her indirect coombs test must be done.

Menstrual cycle Right age. What is menarche?


Why girls should know their blood group?

There are four type of blood groups in human body that is – A, B, AB and O. Your blood group is determined by the genes you inherit from your parents.

Blood groups
There are four type of blood groups

Each group can be either Rh positive or Rh negative, which means total blood groups are eight.

Antibodies and antigens Of the Blood

Blood is made up of red blood cells, white blood cells and platelets in a liquid called plasma. Blood group is identified by antibodies and antigens in the blood.

Antibodies are proteins found in plasma. They’re part of the body’s natural defences. They recognise foreign substances, such as germs, and alert your immune system, which destroys them.

Antigens are protein molecules found on the surface of red blood cells.

Rh Factor in the Blood Groups

Rh factor is an antigen present in RBC. This antigen was discovered by Landsteiner and Wiener. It was first discovered in Rhesus monkey and hence the name ‘Rh factor’. There are many Rh antigens but only the D(this is a protein molecules found surface of red blood cells) antigen is more antigenic in human.

The persons having D antigen are called ‘Rh positive and those without D antigen are called ‘Rh negative Among Indian population, 85% of people are Rh positive and 15% are Rh negative. 

Rh group system is different from ABO group system because, the antigen D does not have corresponding natural antibody (anti-D). However, if Rh positive blood is transfused to a Rh negative person anti-D is developed in that person.

On the other hand, there is no risk of complications if the Rh positive person receives Rh negative blood.


Determination of ABO blood groups depends upon the immunological reaction between antigen and antibody. Landsteiner found two antigens on the surface of RBCs and named them as A antigen and B antigen.


Based on the presence or absence of antigen A and antigen B, blood is divided into four groups:

1. ‘A’ group

2. ‘B’ group

3. ‘AB’ group

4. ‘O’ group.

Blood having antigen A belongs to ‘A’ group. This blood has ß-antibody in the serum. Blood with antigen B and a-antibody belongs to ‘B’ group. If both the antigens are present, blood group is called ‘AB’ group and serum of this group does not contain any antibody.

If both antigens are absent, the blood group is called ‘O’ group and both a and ß antibodies are present in the serum. Antigens and antibodies present in different groups of ABO system Percentage of people among Asian and European population belonging to different blood group

‘A’ group has two subgroups namely ‘A,’ and ‘A’. Similarly ‘AB’ group has two subgroups namely ‘A,B’ and ‘A,B’.

Blood groups
Blood groups Types


A positive means that your blood contains type-A antigens with the presence of a protein called the rhesus (Rh) factor.


People with A+ Blood group can donate blood to

A+ AB+ :


People with A+ Blood group can receive blood from :

A+, A-, O+, O-


A negative platelets are particularly important because they can be given to people from all blood groups. That’s why A negative platelets are called the universal platelet type’


People with A- Blood group can donate blood to:

A+, AB+, B+, AB-


People with A- Blood group can receive blood from :

A-, O-


B positive is an important blood type for treating people with sickle cell disease and thalassemia who need regular transfusions.


People with B+ Blood group can donate blood to:

B+ AB+:


People with B+ Blood group can receive blood from :

A+, A-, O+, O-


B negative blood is one of the rarest blood types as just 2% of our blood donors have it.


People with B- Blood group can donate blood to:

A+, B-, B+, AB-, AB+


People with B- Blood group can receive blood from :

B-, O-


AB positive blood has both A and B antigens at the surface of the red blood cells. People with type AB+ blood are universal recipients.


People with AB+ Blood group can donate blood to:



People with AB+ Blood group can receive blood from :

A-, A+, B-, B+ AB-, AB+, O-, O+


AB negative blood type can receive red blood cells from all negative blood types


People with AB- Blood group can donate blood to:

AB+, AB-


People with AB- Blood group can receive blood from:

A-, O-, AB-, B-


O Positive red blood cells can be transfused to any positive blood types, so it’s still one of the most in-demand blood types.


People with O+ Blood group can donate blood to:

A+, B+, AB+, O+


People with O+ Blood group can receive blood from :

O+, O-


O negative is the universal blood type.lt is the safest blood for transfusions for immune deficient newborns.


People with O- Blood group can donate blood to:

A+, A-, AB-, AB+, B-, B+, O-, O+


People with O- Blood group can receive blood from :


Negative blood group for female is very dangerous in pregnancy. When a mother is Rh negative and fetus is Rh positive (the Rh factor being inherited from the father), usually the first child escapes the complications of Rh incompatibility. This is because the Rh antigen cannot pass from fetal blood into the mother’s blood through the placental barrier.

So female should know about your blood group because lack of awareness many babies can die.

May soon make my own blog on Rh incompatibility

Know all about Rh incompatibility go with this video link  


Sugar, How is it harmful to our body and how to avoid it?

Sugar for our body,  is it harmful? everybody mind has this question. Many people like to eat sweets and because of this habit they invite many diseases by eating more sugar in everything, the amount of sugar in our food will remain large and probably in the coming time we can suffer from very serious diseases like diabetes, obesity

              White Sugar

Guidelines of WHO about Sugar Intake

Seeing the health hazards of the excess sugar in the packaged food, even the World Health Organization (WHO) had to change its guidelines on the amount of sugar intake in our diet.

According to the new guidelines issued in 2015, the WHO recommends adults and children to not consume free sugars more than 10% of their total energy consumption.

A further cut down to 25 grams (6 teaspoons) or 5% of the total energy consumption is associated with more benefits.

About Free Sugar According to WHO

Free sugars, according to the WHO, comprise disaccharides (including table sugar or sucrose) and monosaccharides (like fructose and glucose) added to foods and beverages, and sugars naturally present in fruit juices, honey, syrups, and fruit juice concentrates.

On March 4, 2015, the WHO issued a new guideline to reduce the daily intake of free sugars for adults and children. “We have solid evidence that keeping intake of free sugars to less than 10% of total energy intake reduces the risk of overweight, obesity, and tooth decay.

Making policy changes to support this will be key if countries are to live up to their commitments to reduce the burden of noncommunicable diseases,” explained

Dr Francesco Branca, Director of WHO’s Department of Nutrition for Health and Development.

It is important to note that sugars naturally present in milk and the sugars in vegetables and fresh fruits do not fall under WHO guidelines, as there is no known association between these sugars and any possible adverse effects.

WHO is very particular about sugars ‘hidden’ in processed foods. Generally, people are ignorant of this type of sugar as they mostly relate sugar to sweets or sweetened products.

For instance, free sugars present in 1 tablespoon of ketchup amount to around 1 teaspoon, roughly 4 grams.

Similarly, one can of sugar-sweetened soda delivers around 10 teaspoons or 40 grams free sugars.

The Problem With Sugar

1. Sugar is Linked to Heart Disease

High sugar can cause obesity, inflammation, and more issues that can lead to deadly diseases over time.

It’s also all too easy to consume too much sugar. Just a single can of soda exceeds the recommended daily sugar limit, putting people at risk.

2. Sugar Causes Weight Gain

Today, sugar, not fat, is thought to be the major cause of obesity around the world.

When you consume simple sugars like fructose, you actually start to feel hungry and want to eat more, rather than feeling satiated.

Fructose can even affect the hormones that tell your body when to stop eating, so your body can’t properly regulate hunger anymore.

This is worst in sugary drinks, since they don’t address your hunger, but they add to your daily sugar consumption.

People are more likely to eat more than they need when they’re also consuming a lot of sugar in their beverages.

3. Sugar Leads to Diabetes

Sugar has also been linked to higher rates of diabetes.

Since obesity is the biggest diabetes risk factors, and sugar has been shown to cause obesity, reducing sugar consumption can also reduce the rates of diabetes.

Consuming a lot of sugar leads to insulin resistance, causing high blood sugar levels that increase the risk of diabetes.

4. Sugar is Linked to Depression

Sugar intake has also been linked to higher rates of depression. Depression makes it hard for people to get motivated to work out and make lifestyle changes, creating a negative loop of mental and physical illness.

Research has shown that people who eat a lot of sugar are more likely to become depressed. However, a healthy diet can counteract this effect by boosting your mood.

5. Sugar Has Been Linked to Acne

A diet high in refined carbs, including sugary foods and drinks, has been associated with a higher risk of developing acne.

Foods with a high glycaemic index, such as processed sweets, raise your blood sugar more rapidly than foods with a lower glycaemic index.

Sugary foods quickly spike blood sugar and insulin levels, causing increased androgen secretion, oil production, and inflammation, all of which play a role in acne development.

6. Sugar May Increase Your Risk of Cancer

Eating excessive amounts of sugar may increase your risk of developing certain cancers.

First, a diet rich in sugary foods and beverages can lead to obesity, which significantly raises your risk of cancer. Furthermore, diets high in sugar increase inflammation in your body and may cause insulin resistance, both of which increase cancer risk.

7. Sugar May Accelerate the Skin Ageing

Process Wrinkles are a natural sign of ageing. They appear eventually, regardless of your health. However, poor food choices can worsen wrinkles and speed the skin ageing process.

Advanced glycation end products are compounds formed by reactions between sugar and protein in your body. They are suspected to play a key role in skin ageing.

Consuming a diet high in refined carbs and sugar leads to the production of AGES, which may cause your skin to age prematurely.

AGEs damage collagen and elastin, which are proteins that help the skin stretch and keep its youthful appearance. When collagen and elastin become damaged, the skin loses its firmness and begins to sag.

8. Sugar Can Lead to Fatty Liver

A high intake of fructose has been consistently linked to an increased risk of fatty liver. Unlike glucose and other types of sugar, which are taken up by many cells throughout the body, fructose is almost exclusively broken down by the liver. In the liver, fructose is converted into energy or stored as glycogen.

However, the liver can only store so much glycogen before excess amounts are turned into fat. Large amounts of added sugar in the form of fructose overload your liver, leading to non-alcoholic fatty liver disease (NAFLD), a condition characterized by an excessive fat build-up in the liver.

Avoid taking too much sugar and save yourself from diseases and follow the right way of diet because if you have life you have the world.

Eating Disorders, Causes, Symptoms and Treatment

Eating disorders is phychological condition that involve extreme disturbances in eating behavior. Eating disorders are serious mental health disorders. They involve severe problems with your thoughts about food and your eating behaviours. You may eat much less or much more than you need.

Anorexia Nervosa self-induced starvation to a significant degree,

(1) a relentless drive for thinness or a morbid fear of fatness,

(2) the presence of medical signs and symptoms resulting from starvation. It is often associated with disturbances of body image-the perception that one is distressingly large despite obvious thinness.

Epidemiology of Eating Disorders

The most common age of onset is between 14 and 18 years. Anorexia Nervosa is estimated to occur in about 0.5% to 1% of adolescent girls. It occurs 10 to 20 times more often in females than in males.

The prevalence of young women with some symptoms of anorexia nervosa who do not meet the diagnostic criteria is estimated to be close to 5%.

It seems to be most frequent in developed countries, and it may be seen with greatest frequency among young women in professions that require thinness, such as modeling and ballet.

Causes Of Eating Disorders 

Biological, social, and psychological factors are implicated in the causes of anorexia nervosa.

Some evidence points to higher concordance rates in mono-zygotic twins than in dizygotic twins.

Major mood disorders are more common in family members than in the general population.

Biological factors.

Starvation results in many biochemical changes, some of which are also present in depression, such as hypercortisolemia and non suppression by dexamethasone. An increase in familial depression, alcohol dependence, or eating disorders has been noted.

Some evidence of increased anorexia nervosa. Neurobiologically, a reduction in 3-methoxy-4-hydroxyphenylglycol (MHPG) in urine and cerebrospinal fluid (CSF) suggests lessened norepinephrine turnover and activity.

Endogenous opioid activity appears lessened as a conse quence of starvation. In one positron emission tomography (PET) study, caudate nucleus metabolism was higher during the anorectic state than after weight gain.

Magnetic resonance imaging (MRI) may show volume deficits of gray matter during illness, which may persist during recovery. A genetic predisposition may be a factor.

Social factors

Patients with anorexia nervosa find support for their practices in society’s emphasis on thinness and exercise. Families of children who present with eating disorders, especially binge-eating or purging subtypes, may exhibit high levels of hostility, chaos, and isolation and low levels of nurturance and empathy.

Vocational and avocational interests interact with other vulnerability factors to increase the probability of developing eating disorders (i.e., ballet in young women and wrestling in high school boys).

Psychological and psychodynamic factors.

Patients with the disorder substitute their preoccupations, which are similar to obsessions, with eating and weight gain for other, normal adolescent pursuits. These patients typically lack a sense of autonomy and self-hood.

Diagnosis and clinical features.

The onset of anorexia nervosa usually occurs between the ages of 10 and 30 years. It is present when

(1) An individual voluntarily reduces and maintains an unhealthy degree of weight loss or fails to gain weight proportional to growth.

(2) An individual experiences an intense fear of becoming fat, has a relentless drive for thinness despite obvious medical starvation, or both.

(3) An individual experiences significant starvation-related medical symptomatology, often, but not exclusively abnormal reproductive hormone functioning, but also hypothermia, bradycardia, orthostasis, and severely reduced body fat stores.

(4) The behaviours and psychopathology are present for at least 3 months Obsessive-compulsive behavior, depression, and anxiety are other psychiatric symptoms of anorexia nervosa most frequently noted in the literature Poor sexual adjustment is frequently described in patients with the disorder.

Anorexia Nervosa patient often give a history of a few or no sexual experience and generally have low libido, whereas bulimia patients are often sexually active with a normal or high libido.

Very soon I will write on bulimia nervosa.

Type Of Eating Disorder

1. Restricting type (no binge eating)

Present in approximately 50% of cases. Food intake is highly restricted (usually with attempts to consume fewer than 300 to 500 calories per day and no fat grams), and the patient may be relentlessly and compulsively overactive, with overuse athletic injuries. Persons with restricting anorexia nervosa often have obsessive compulsive traits with respect to food and other matters.

2. Binge-eating/purging type

Patients alternate attempts at rigorous dieting with intermittent binge or purge episodes, with the binges, if present, being either subjective (more than the patient intended, or because of social pressure, but not enormous) or objective.

Purging represents a secondary compensation for the unwanted calories, most often accomplished by self-induced vomiting, frequently by laxative abuse, less frequently by diuretics, and occasionally with emetics. The suicide rate is higher than in those with the restricting type.

Pathology and laboratory examination

A complete blood count often reveals leukopenia with a relative lymphocytosis in emaciated patients with anorexia nervosa. If binge eating and purging are present, serum electrolyte determination reveals hypokalemic alkalosis.

Fasting serum glucose concentrations are often low during the emaciated phase, and serum salivary amylase concentrations are often elevated if the patient is vomiting.

The ECG may show ST-segment and T-wave changes, which are usually secondary to electrolyte disturbances; emaciated patients have hypo-tension a bradycardia. 

Differential diagnosis

1.Medical conditions and substance use disorders. Medical illness (e.g.. cancer, brain tumor, gastrointestinal disorders, drug abuse) that can account for weight loss.

2.Depressive disorder- Depressive disorders and anorexia nervosa have several features in common, such as depressed feelings, crying spell sleep disturbance, obsessive ruminations, and occasional suicidal thoughts.

However, generally a patient with a depressive disorder has decreased appetite, whereas a patient with anorexia nervosa claims to have normal appetite and feels hungry; only in the severe stages of anorexia nervosa do patients actually have a decreased appetite.

Also, in contrast to depressive agitation, the hyperactivity seen in anorexia nervosa is planned and ritualistic. The preoccupation with recipes, the caloric content of foods, and the preparation of gourmet feasts is typical with anorexia ner vosa not with depressive disorder.

In depressive disorders, patients have no intense fear of obesity or disturbance of body image. Comorbid major depression or dysthymia has been found in 50% of patients with anorexia.

3. Somatization disorder. Weight loss not as severe; no morbid fear becoming overweight; amenorrhea unusual.

4. Schizophrenia. Delusions about food (e.g., patients believe the food to be poisoned). Patients rarely fear becoming obese and are not as hyperactive.

5. Bulimia nervosa. Patient’s weight loss is seldom more than 15%. Bulimia nervosa develops in 30% to 50% of patients with anorexia nervosa with 2 years of the onset of anorexia.

Treatment Of Eating Disorders

Hospitalization. The first consideration in the treatment of anorexia ner. vosa is to restore patients’ nutritional state. Patients with anorexia nervosa who are 20% below the expected weight for their height are recommended for inpatient programs, and patients who are 30% below their expected weight require psychiatric hospitalization for 2 to 6 months.

Inpatient psychiatric programs for patients with anorexia nervosa generally use a combination of a behavioral management approach, individual psychotherapy, family education and therapy, and, in some cases, psychotropic medications.

Patients must become willing participants for treatment to succeed in the long run. After patients are discharged from the hospital, clinicians usually find it necessary to continue outpatient supervision of the problems identified in the patients and their families.

Psychotherapy Treatment 

Cognitive-behavioral therapy (CBT). Cognitive and behavioral therapy principles can be applied in both inpatient and outpatient settings.

Behavior therapy has been found effective for inducing weight gain; no large, c trolled studies of cognitive therapy with behavior therapy in patients with anorexia nervosa have been reported.

Patients are taught to monitor their food intake, their feelings and emotions, their binging and purging behaviors, and their problems in interpersonal relationships.

Patients are taught cognitive restructuring to identify automatic thoughts and to challenge their core beliefs. Problem solving is a specific method whereby patients learn how to think through and devise strategies to cope with their food-related and interpersonal problems. Patients’ vulnerability to rely on anorectic behavior as a means of coping can be addressed if they can learn to use these techniques effectively.

Dynamic Psychotherapy. Patients’ resistance may make the process difficult and painstaking. Because patients view their symptoms as constituting the core of their specialness, therapists must avoid excessive investment in trying to change their eating behavior.

The opening phase of the psychotherapy process must be geared to building a therapeutic alliance. Patients may experience early interpretations as though someone else were telling them what they really feel and thereby minimizing and invalidating their own experiences.

Therapists who empathize with patients’ points of view and take an active interest in what their patients think and feel, however, convey to patients that their autonomy is respected. Above all, psychotherapists must be flexible, persistent, and durable in the face of patients’ tendencies to defeat any efforts to help them.

Family Therapy. A family analysis should be done for all patients with anorexia nervosa who are living with their families, as a basis for a clinical judgment on what type of family therapy or counseling is advisable.

In some cases, family therapy is not possible; how ever, issues of family relationships can then be addressed in individual therapy. Sometimes, brief counseling sessions with immediate family members is the extent of family therapy required.

Pharmacotherapy. Some reports support the use of cyproheptadine (Periactin), a drug with antihistaminic and antiserotonergic properties, for patients with the restricting type of anorexia nervosa. Amitriptyline (Elavil) has also been reported to have some benefit.

Concern exists about the use of tricyclic drugs in low-weight, depressed patients with anorexia nervosa, who may be vulnerable to hypotension, cardiac arrhythmia, and dehydration.

Once an adequate nutritional status has been attained, the risk of serious adverse effects from the tricyclic drugs may decrease; in some patients, the depression improves with weight gain and normalized nutritional status.

Eating Disorder Not Otherwise Specified The text revision of the fourth edition of the Diagnostic Statistical Manual of Mental Disorders (DSM-IV-TR) diagnostic classification eating disorder not otherwise specified is a residual category used for eating disorders that do not meet the criteria for a specific eating disorder.

Binge-eating disorder that is, recurrent episodes of binge eating in the absence of the inappropriate compensatory behaviors characteristic of bulimia nervosa falls into this category. Such patients are not fixated on body shape and weight.

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Obesity, how does it affect the body? Causes, Treatment

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Obesity, how does it affect the body? Causes, Treatment

Obesity may be defined as an abnormal excess deposition of fat in the body. Obesity is caused due to increased size (hypertrophy) or increased number (hyperplasia) of adipocytes or both.

Obesity is the major cause of overweight. Obesity & overweight according to reference height-weight table have to be carefully reviewed in terms of the lean body mass and body muscle to fat.

An athlete will have highly developed muscle mass and therefore may be overweight according to reference height – weight table.

But athletes body has more muscle mass than fat in proportion. Therefore, obesity is not only a matter of weight. One must be able to distinguish between weight due to well developed muscle mass (athletes) and due to excessive fat deposition.

Obesity definition

In simple words, overweight is usually due to obesity but also can arise due to excess muscle development. It can also be caused due to abnormal fluid retention.

Obesity refers to an excess of body fat. In healthy individuals, body fat accounts for approximately 25% of body weight in women and 18% in men.

Overweight refers to weight above some reference norm, typically standards derived from actuarial or epidemiological data. In most cases, increasing weight reflects increasing obesity.

Body mass index (BMI) is calculated by dividing weight in kilograms by height in meters squared.

Although there is debate about the ideal BMI, it is generally thought that a BMI of 20 to 25 kg² represents healthy weight, 

A BMI of 25 to 27 kg2 is associated with somewhat elevated risk,

A BMI above 27 kg/m² represents clearly increased risk, and a BMI above 30 kg/m² carries greatly increased risk.

In the United States, over 50% of the population is overweight (defined as a BMI of 25.0 to 29.9 kg/m²), whereas 30% are obese (defined as a BMI >30 kg/m²).

Extreme obesity (BMI ≥40 kg/m²) is found in about 3% of men and 7% of women.

The prevalence of obesity is highest in minority populations, particularly among non-Hispanic black women.

More than one half of these individuals 40 years of age or older are obese and more than 80% are overweight.

The prevalence of overweight and obesity in children and adolescents in the United States has also increased substantially.

About 18% of adolescents and about 10% of 2 to 5-year-olds are overweight.

Causes of Obesity

Obesity results from a chronic imbalance between energy intake and energy expenditure. Major contributing factors are excessive calorie consumption more than the body need and / or lack of physical activity.

Genetic (hereditary) factors also contribute to the condition.

Obesity can also result from hormonal disorders like hypothyroidism, hypogonadism, Cushing’s syndrome and hypopituitarism.

Persons accumulate fat by eating more calories than are expended as energy, thus intake of energy exceeds its dissipation.

If fat is to be removed from the body, fewer calories must be put in or more calories must be taken out than are put in.

An error of no more than 10% in either intake or output would lead to a 30-pound change in body weight in 1 year’s time.

Satiety. The feeling that results when hunger is satisfied is satiety. A metabolic signal derived from food receptor cells, probably in thehypothalamus, produce satiety.

Studies have shown evidence for dysfuntion in serotonin, dopamine, and norepinephrine involvement in reguleing eating behavior through the hypothalamus.

Other hormonal fact that may be involved include corticotrophin releasing factor, neuropetide Y, gonadotropin-releasing hormone, and thyroid-stimulating hormone.

A new substance, obestatin, made in the stomach, is a hormone that, in animal experiments, produces satiety and may have potential as a weight-loss agent in humans.

Eating is also affected by cannabinoid receptors, which, when stim lated, increases appetite.

Olfactory system. The olfactory system may play a role in satiety. Expreiments have shown that strong stimulation of the olfactory bulbs in the nose with food odors by use of an inhaler saturated with a particular sm produces satiety for that food. This may have implications for t obesity. therapy 

Factors that Contribute to Obesity

Genetic factors

About 80% of patients who are obese have a fam history of obesity, although no specific genetic marker of obesity been found.

Studies show that identical twins raised apart can both be obese, an observation that suggests a hereditary role.

Developmental factors

Obesity that begins early in life is characterized by adipose tissue with an increased number of adipocytes (fat cells) of increased size.

Obesity that begins in adult life, on the other hand, results solely increase in the size of the adipocytes. In both instances, weight reduction produces a decrease in cell size.

Physical activity factors.

The marked decrease in physical activity affluent societies seems to be the major factor in the rise of obesity a public health problem.

Physical inactivity restricts energy expe ture and may contribute to increased food intake. Although food inta increases with increasing energy expenditure over a wide range of energy demands, intake does not decrease proportionately when physical activ falls below a certain minimum level.

Psychological factors. Although psychological factors are evidently crucial to the development of obesity, how such psychological factors result in obesity is not known.

Health factors

In only a small number of cases of obesity, the consequence is identifiable illness.

Such cases include a variety of rare genetic disorders, such as Prader-Willi syndrome, as well as neuroendocrine abnormal ities.

Hypothalamic obesity results from damage to the ventromedial region of the hypothalamus (VMH), which has been studied exten sively in laboratory animals and is a known center of appetite and weight regulation.

In humans, damage to the VMH may result from trauma, surgery, malignancy, or inflammatory disease.

Some forms of depression, particularly seasonal affective disorder, are associated with weight gain.

Most persons who live in seasonal climates report increases in appetite and weight during the fall and winter months, with decreases in the spring and summer. Depressed patients usually lose weight, but some gain weight.

Clinical disorders

A variety of clinical disorders are associated with obesity. Cushing’s disease is associated with a characteristic fat distri bution and moonlike face.

Myxedema is associated with weight gain, although not invariably. 

Psychotropic drugs. Long-term use of steroid medications is associated with significant weight gain, as is the use of several psychotropic agents.

Patients treated for major depression, psychotic disturbances, and bipolar disorder typically gain 3 to 10 kg, with even larger gains with chronic use. This can produce the so-called metabolic syndrome.

Obesity has adverse effects on health and is associated with a broad range of illnesses. There is a strong correlation between obesity a cardiovascular disorders.

Hypertension (blood pressure > 160/95 Hg) is three times higher for persons who are overweight, and hypholesterolemia (blood cholesterol >250 mg/dL) is twice as common.

Recovery Rate

The recovery for weight reduction is poor, and the course of obesity tends toward inexorable progression. Of patients who lose significant amounts of weight, 90% regain it eventually.

The recovery is particularly poor for those who become obese in childhood.

Juvenile-onset obesity tends to be more severe, more resistant to treament, and more likely to be associated with emotional disturbance then is adult obesity.

Complications of obesity

Obese persons are more prone to diabetes mellitus (Type II), coronary heart disease (like artherosclerosis, hypertension) and conditions like fungal infection etc.


The basis of weight reduction is simple-establish a caloric deficit by bringing intake below output. The simplest way to reduce caloric intake is by means of a low-calorie diet.

The best long-term effects are achieved with a balanced diet that contains readily available foods, For most persons, the most satisfactory reducing diet consists of their usual foods in amounts determined with the aid of tables of food values that are available in standard books on dieting.

Such a diet gives the best chance of long-term maintenance of weight loss.

Total unmodified fasts are used for short-term weight loss, but they have associated morbidity including orthostatic hypotension, sodium diuresis, and impaired nitrogen balance

Ketogenic diets are high-protein, high-fat diets used to promote weight loss. They have a high cholesterol content and produce ketosis, which is associated with nausea, hypotension, and lethargy.

In general, the best method of weight loss is a balanced diet of 1,100 to 1.200 calories. Such a diet can be followed for long periods but should be supplemented with vitamins, particularly iron, folic acid, zinc, and vitamin B.


1- Increased physical activity is an important part of a weight-reduction regimen. Because caloric expenditure in most forms of physical activ ity is directly proportional to body weight, obese persons expend more calories than persons of normal weight with the same amount of activity.

2. Increased physical activity may actually decrease food intake by formerly sedentary persons. This combination of increased caloric expenditure and decreased food intake makes an increase in physical activity a highly desirable feature of any weight-reduction program.

3. Exercise also helps maintain weight loss.

Lumbar Spondylosis, Causes, Symptoms and Treatment

Lumbar Spondylosis is a degenerative disorder of the lumbar spine characterised clinically by an insidious onset of pain and stiffness of the spine.

Causes of Lumbar Spondylosis

Bad posture and chronic back strain is the commonest cause.

Other causes are, previous injury to the spine, previous disease of the spine, birth defects and old intervertebral disc prolapse.

Normally this time many persons job type are sitting job that is the major reason of Lumbar Spondylosis because they are sit in same position several hours.

Symptoms of Lumbar Spondylosis

The symptoms begin as Low Backache,

Initially worst during activity, but later present almost all the sime.

There may be a feeling of “a catch while getting up from a sitting position, which improves as one walks a few steps.

The pain may radiate down the limb up to the calf (sciatica) because of irritation of one of the nerve root.

There may be complaint of transient numbness and paresthesia in the dermatome of a nerve root, commonly on the lateral side of leg or foot (L5. S1 roots) respectively.


Primarily, degeneration begins in the intervertebral joints. This is followed by a reduction in the disc space and marginal osteophyte formation.

Degenerative changes develop in the posterior facet joints. Osteophytes around the intervertebral foramen may encroach upon the nerve root canal, and thus interfere with the functioning of the emerging nerve.


The spinal movements are limited terminally, but there is little muscle spasm.

The straight leg raising test (SLRT) may be positive if the nerve root compression is present.


Good AP and lateral views of the lumbo-sacral spine. should be done after preparing the bowel with a mild laxative and gas adsorbent like charcoal tablets.

Lumbar Spondylosis
X-Ray of the Lumbosacral spine,     showing Lumbar Spondylosis

It is particularly difficult in obese patients, the ones usually suffering from this disease. Following signs may be present:

1-Reduction of disc space

2-Osteophyte formation

3-Narrowing of joint space of the facet joints

4-Subluxation of one vertebra over anotherT

Treatment of Lumbar Spondylosis

Principles of treatment: Like cervical spondylosis, lumbar spondylosis also undergoes spontaneous remissions and exacerbations.

Treatment is essentially similar to cervical spondylosis. In the acute stage, bed rest, hot fomentation and analgesics are advised.

As the symptoms subside, spinal exercises are advised. In some resistant cases, a lumbar corset may have to be used at all times. Spinal fusion may occasionally be necessary.

If the pain is sever so You can apply Shortwave diathermy.

Application of Shortwave Diathermy

Position of the patient: Prone lying with adequate support posteriorly.

1-Methods: Monoplanar

2-Spacing: Narrow


1-Acute: Subthermal .

2-Subacute: Mildthermal

3-Chronic: Thermal


Menstrual cycle Right age. What is menarche?

Menstrual cycle is defined as cyclic events that take place in a rhythmic fashion during the reproductive period of a woman’s life.

Every girl should know about menarche. Menarche is the first period of your life. When girls has passed her puberty age and then turn into maturity age menstrual cycle has started . First menstruation called menarche.

Menstrual cycle right age

Menstrual cycle starts at the age of 11 to 15 years, which marks the onset of puberty. There is no definite age of the first period. It depends on her mother. When her mother first menstruated so daughter first menstruation date almost be there.

As time goes our life style also changing. One of the most common resion girl has started her mensuration early age. 

In earlier time girl used to have menstruation at the age of around 15-16.

The commencement of menstrual cycle is called menarche. Menstrual cycle ceases at the age of 45 to 50 years. Permanent cessation of menstrual cycle in old age is called menopause.

Myth about Menarche/ Menstrual

Can Menarche affect of hight- There is no relation between height and menstrual cycle. Menarche doesn’t affect of the final height. Final height depend upon our life style and physical activity and it is also depends on her parents height. If her parents height is short there is highly chances to their children height could be short.

Should girl take a bath during menstruation or not? – 

This is an ancient tradition, which even in today’s times, many orthodox people believe it. Rather, during the period, girls should take care of cleanliness even more. She can save many disease. Hygiene is more important during  menstruation. So please take a daily bath and maintain your hygiene  this a normal process of our body.

Always use senetory pad doesn’t use any cloth if you are using cloth make sure it is germ free. Many circumstances pad is not available or everyone couldn’t buy pad so please use germ free and clean cloth. Don’t reuse it. If you don’t do this it can causes many infection.

Change During Menarche or menstrual cycle.

During each menstrual cycle, series of changes occur in ovary and accessory sex organs.

These changes are divided into 4 groups:

1. Ovarian changes

2. Uterine changes

3. Vaginal changes

 4. Changes in cervix.

All these changes take place simultaneously.


Changes in the ovary during each menstrual cycle occur in two phases:

A. Follicular phase

B. Luteal phase.

Ovulation occurs in between these two phases.


Follicular phase extends from the 5th day of the cycle until the time of ovulation, which takes place on 14th day. Maturation of ovum with development of ovarian follicles takes place during this phase.


Ovulation is the process by which the graafian follicle ruptures with consequent discharge of ovum into the abdominal cavity. It is influenced by LH. Ovulation occurs on 14th day of menstrual cycle in a normal cycle of 28 days. The ovum enters the fallopian tube.


Luteal phase extends between 15th and 28th day c menstrual cycle. During this phase, corpus luteum is developed and hence this phase is called luteal phase.



During each menstrual cycle, along with ovarian changes, uterine changes also occur simultaneously. Uterine changes occur in three phases:

1. Menstrual phase

2. Proliferative phase

3. Secretory phase.


After ovulation, if pregnancy does not occur, the thickened endometrium is shed or desquamated. This desquamated endometrium is expelled out through vagina along with blood and tissue fluid.

The process of shedding and exit of uterine lining along with blood and fluid is called menstruation or menstrual bleeding. It lasts for about 4 to 5 days.

This period is called menstrual phase or menstrual period. It is also called menses, emmenia or catamenia.

The day when bleeding starts is considered first day of the menstrual cycle.

Two days before the onset of bleeding, that is on 26th or 27th day of the previous cycle, there is a sudden reduction in the release of estrogen and progesterone from ovary.

Decreased level of these two hormones is responsible for menstruation.

Proliferative phase

Extends usually from 5th to 14th day of menstruation, i.e. between the day when menstruation stops and the day of ovulation. It corresponds to the follicular phase of ovarian cycle.

At the end of menstrual phase, only a thin layer (1 mm) of endometrium remains, as most of the endo metrial stroma is desquamated.


Secretory phase extends between 15th and 28th day of the menstrual cycle, i.e. between the day of ovulation and the day when menstruation of next cycle commences.


Regulation of menstrual cycle is a complex process that is carried out by a well organized regulatory system.

The regulatory system is a highly integrated system, which includes hypothalamus, anterior pituitary and ovary with its growing follicle. In the whole scenario, the growing follicle has a vital role to play.



Menstrual symptoms are the unpleasant symptoms with discomfort, which appear in many women during menstruation. These symptoms are due to hormonal withdrawal, leading to cramps in uterine muscle before or during menstruation.

Common Menstrual Symptoms

1. Abdominal pain

2. Dysmenorrhea (menstrual pain)

3. Headache Occasional nausea and         vomiting

5. Irritability

6. Depression

7.Migraine (neurological disorder, characterized by intense headache causing disability


Premenstrual syndrome (PMS) is the symptom of stress that appears before the onset of menstruation.

It is also called premenstrual stress syndrome, premenstrual stress or premenstrual tension. It lasts for about 4 to 5 days prior to menstruation. Symptoms appear due to salt and water retention caused by estrogen

Common Feature

1. Mood swin

2. Anxiety

3. Irritability

4. Emotional instability

5. Headache

6. Depression

7. Constipation

8. Abdominal cramping

9. Bloating (abdominal swelling)


1. Amenorrhea:

Absence of menstruation

2. Hypomenorrhea:

Decreased menstrual bleeding.

3. Menorrhagia:

Excess menstrual bleeding

4. Oligomenorrhea:

Decreased frequency of menstrual


5. Polymenorrhea:

Increased frequency of menstruation

6. Dysmenorrhea:

Menstruation with pain

7. Metrorrhagia:

Uterine bleeding in between  menstruations.


Anovulatory cycle is the menstrual cycle in which ovulation does not occur.

The menstrual bleeding occurs but the release of ovum does not occur. It is common during puberty and few years before menopause.

When it occurs before menopause, it is called perimenopause. If it occurs very often during childbearing years, it leads to infertility.

Common Causes

1.Hormonal imbalance

2.Prolonged strenuous exercise program

3.Eating disorders

4.Hypothalamic dysfunctions 5. Tumors in pituitary gland, ovary or adrenal gland

6.Long-term use of drugs like steroidal oral contraceptives.

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