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Nov 23rd 2018
Why so many women want this contraceptive pill banned
After the death of one young woman from Rigevidon, and the serious health complications of many more, there are calls to stop the contraceptive pill from being offered on the NHS.
hree years ago, 483 young women turned up to Tamworth’s family planning clinic during a week in May - all demanding to be taken off their contraceptive pills. When it was her turn to reach the front desk, Yasmin* was asked why. “The pill just killed my best friend,” she responded.
More than 100 million women around the world use the combined oral contraceptive pill. Whatever brings you to the doctor’s surgery requesting it, the outcome is often the same. After a couple of minutes, you'll leave with a three-month supply.
For Fallan Kurek, a 20-year-old teaching assistant, it was heavy periods that left her seeking help from her GP. She wasn’t sexually active, but was given Microgynon in October 2014 to help with her irregular cycle.
When she went to get a new supply of the pill in May 2015, Fallan was switched onto a cheaper alternative, Rigevidon. The doctor outlined that it had exactly the same hormonal ingredients; just a different name. Fallan was neither overweight nor a smoker, so was deemed ‘low risk’ by the doctor who prescribed her Rigevidon without running through the potential side effects.
Three weeks later, complaining of leg pain, the 19-year-old went back to her GP. She was told she was fine. When she had chest pain and collapsed a few days after that, Fallan went to the local hospital only to be told it was a panic attack, and that she would be okay.
Three days later, Fallan collapsed once more. It was a blood clot, and she never regained consciousness.
Written in black and white, on Fallan’s death certificate, is confirmation that her cause of death was the contraceptive pill. That something so small could take away something so precious clouded Fallan’s mum, Julia, with paralysing shock.
The GP told the family Fallan’s case was the exception not the rule; the stats say Fallan’s death was 1 in 10,000. But to her loved ones, it didn’t matter about the statistics. It was a devastating loss.
Three years on, you only need to type ‘Rigevidon’ into Google to see what impact Fallan’s death had on other young women also taking that pill. Link after link guides you to petitions, message threads and blogs sharing other negative experiences of the pill. A post in The Student Room about Rigevidon, started in 2015, is still being added to in 2018. The anonymous woman who started the thread wrote: “This pill is making me crazy. What I want to know is if anyone else has experienced this same thing on Rigevidon or any other pill?”
Chelsea Lawton was one of the women who responded. She tells Cosmopolitan UK Rigevidon caused her to have “extreme sickness, headaches and irregular bleeding.”
“I felt as though I had really bad anxiety and depression to the point that I didn’t want to leave the house,” she recalls. Since coming off Rigevidon, Chelsea says she finally feels like herself again.
Lola* also suffered unusual symptoms after being switched over to Rigevidon, but tried to ignore them until the advised three months had passed. “I started experiencing horrible cramps in my abdomen,” she says. “They were so bad, it felt like my insides were falling out. Just a couple of hours later my uterus lining started coming out of me. That’s when I knew I’d had enough.”
Yolanda* says her symptoms came on like “a ton of bricks”.
“I suffered from a clot in my brain in 2014 due to this pill. I didn’t realise it was so common,” she tells Cosmopolitan UK.
For most of us, the pill is extremely safe. As well as being a form of contraception, it can also provide health benefits including a reduced cancer risk, relief from acne, painful periods, premenstrual syndrome, polycystic ovaries and endometriosis. But that doesn’t mean it comes without side effects.
For one in every 10 pill-takers, there’ll be headaches, spots, mood swings (including depression), a reduced libido, breast pain, nausea, irregular bleeding, a change in weight, or unusual discharge that come along for the ride.
For one in every 100 women on the pill, there’ll be a change in appetite, elevated blood pressure, abdominal cramps, bloating and rashes.
And for one in every 10,000 people on the pill, there’ll be the ‘very rare side effects’. A tumour of the liver, immune system disease, inflammation of organs, blood clots.
So what is it about this pill that means the side effects are so much more common? Why is there an online petition with more than 27,000 signatures – set up by a woman who suffered a blood clot and a stroke herself as a result of this exact contraceptive - to get Rigevidon banned from the NHS?
If you break it down, Rigevidon is a contraceptive pill containing 30 mcg Ethinylestradiol (the hormone oestrogen) and 150 mcg Levonorgestrel (the hormone progesterone). As far as the hormone content is concerned, it is identical to other pills which have been on the market for decades, including Microgynon and Ovranette. Rigevidon has been available for the last few years as an alternative to these, and was introduced largely on the basis of reduced cost (it costs 3p per pack to produce).
Gynaecologist Dr Anne Henderson tells Cosmopolitan UK that, while Rigevidon is pharmacologically identical to other pills, her view is that “the additional constituents in Rigevidon, such as the binding agents which help form a stable pill, may be the issue. Even slight variations in the pharmacology of the combined pill such as this could impact on the way in which the pill is absorbed and thus any potential side effects.”
Dr Henderson tells us on an anecdotal basis that, in her own practice, she has noticed a rise in concerns amongst women she sees who have been prescribed Rigevidon. “I believe that these are legitimate concerns and they certainly appear to be more frequent than with other combined pills,” she said.
Abbas Kanani, a pharmacist at Chemist Click, has also observed a large number of females complaining about the side effects, specifically from Rigevidon. However, he also emphasises that the serious risks, like blood clots, are extremely rare and notes that “the benefits outweigh the risk”.
It is on this precise basis that contraceptive pills are prescribed on the NHS. As with any medication, they present risk, but their value in the prevention of unwanted pregnancy predominantly outweighs this. It is the job of the health professional who prescribes the contraceptive pill to warn the patient about side effects and what to look out for - but that may well be where the problem lies with Rigevidon.
As women online share their experiences of the pill and tag their friends, what really stands out is how many women say the same thing: “I wasn’t told of the risks.”
ulia Kurek, Fallan’s mother, was at the appointment where her daughter was handed Rigevidon. She insists they were not warned of any potential side effects of the contraceptive. “The warning signs to look out for aren’t widely known, that’s what gets me,” Julia tells Cosmopolitan UK.
When the grieving mother later asked medical professionals why they hadn’t been warned of possible risks, she alleges they said: “We don’t like to scare them, we don’t want to scaremonger.”
But how can it be scaremongering if it’s potentially lifesaving information? That valuable information is printed in a leaflet - deceivingly small, until it’s unfolded – that comes inside every pill packet. But how many women actually read it?
It was women who fought long and hard for the warning leaflet to be included inside the pill packet in the first place. When the first large-scale clinical trial on the pill took place in Puerto Rico in 1955, 17 percent of the women suffered significantly unpleasant side effects. In her first report, Dr. Edris Rice-Wray - medical director of the Puerto Rico Family Planning Association and the woman heading up the trials - said that, while the pill provided nearly 100 percent protection against unwanted pregnancies, it caused too many side reactions to be deemed acceptable.
The men who had ordered the research went ahead with the widespread production of the contraceptive pill anyway.
Years later, with ever-building evidence of blood clots as a side effect, women campaigned heavily. Their activism eventually led to the existence of an advisory leaflet being tucked away inside every packet of the pill – the ones we still see today. But if women aren’t being actively told by their healthcare providers just how important the information contained inside it really is - it’s not surprising that so many wouldn’t recognise potentially serious symptoms if they were to occur.
“Clinicians need to tell women about risks, and women need to listen,” Dr Sarah Hardman, Director of the Faculty of Sexual and Reproductive Healthcare (FSRH) tells Cosmopolitan UK, stressing the necessity of a two-way process.
Being prescribed Rigevidon isn’t an inevitable death sentence. Plenty of women have switched over to it with no issue whatsoever. And if it provides a cost-saving mechanism for an NHS that is increasingly drowning in financial shortcomings, then the benefit of Rigevidon is indisputable.
But not at the expense of people’s lives.
The combined oral contraceptive pill isn’t suitable for all women. If you are over 50, have a high BMI, smoke or have a family history of deep venous thrombosis (blood clots), then it is likely your GP or family planning clinic will suggest a different option for you.
If you do take the pill, these are the high-risk symptoms to look out for:
April 10th 2018
Antidepressants during pregnancy can affect baby's brain health, finds study
Mothers using antidepressants during pregnancy may cause anxiety disorders in their children later in life because the drugs can interfere with the normal development of the foetal brain, a study has found.
US doctors have called for more research on the long-term impact of selective serotonin reuptake inhibitors (SSRIs) after finding babies exposed to the drugs in the womb developed differently.
The widely used antidepressants are a key tool in treating depression and are becoming more common in pregnancy as they can help prevent maternal suicides – the leading cause of death among women in their first year after giving birth.
But using advanced MRI techniques the researchers found two parts of the brain, the right amygdala and right insula, were larger and more connected in newborns whose mothers were given SSRIs than those whose mothers had untreated depression, or who were depression free.
These changes are important, the authors say in a paper published today in the JAMA Neurology journal, because “abnormalities in the amygdala-insula circuitry may be associated with anxiety and depression”.
The team, led by doctors at the Department of Psychiatry at Columbia University Medical Centre, New York, scanned 98 infants for the research.
Sixteen of the babies had mothers whose depression had been treated with SSRIs during their pregnancy, 21 infants had mothers with untreated depression and the remaining 61 had mothers with no history of depression.
They conclude that the differences in brain size and connectivity between the SSRI group and the other two are most likely to be caused by the drugs disrupting the levels of the chemical serotonin at key parts of the brain’s development.
Serotonin is a major neurotransmitter which sends messages between nerve cells in the brain and other parts of the body, and plays a major role in mood, the sleep-wake cycle and constricting of muscles in the gut.
Studies have shown SSRI use becoming more common in treating maternal depression, rising in one US treatment area from 5.7 per cent of pregnancies in 1999 to 13.4 per cent in 2003, but there is limited understanding of their effects.
The authors conclude that because untreated depression “poses risks to both the infant and mother” the decision on when and how long to use them is a “clinical dilemma” for psychiatrists.
While they were able to show brain changes the authors say future studies should look at any increased risk of depressive, cognitive or movement abnormalities later in life for these infants – as this information could help resolve the treatment dilemma.
Independent academics said the findings were the first to show such a link and warranted further investigation; however, they said there were other limitations to the study that could also contribute to these changes.
Andrew Whitelaw, emeritus professor of neonatal medicine at the University of Bristol said differences in the socioeconomic backgrounds of the mothers was significant in the study.
The majority (75 per cent) of those receiving SSRIs were white, well educated and well off, while 61 per cent of the non-SSRI depressed group were earning less than $25,000 (£17,700) a year and only 14 per cent were white: differences which could impact upon the other stresses the children faced during pregnancy and in later childhood.
But, he added: “The current findings are original and build on previous research in Finland showing that SSRI-treated mothers have children with an increase in depression in adolescence.
“Wisely, the authors do not conclude that SSRI treatment should be avoided in pregnancy. Untreated depression in pregnancy has serious risks for mother and baby and psychiatrists have the difficult task of identifying the pregnant women where SSRI treatment is the least risky decision.”
April 4th 2018
Babies at risk of being put in unsafe sleep positions by babysitters
Babies who died in their sleep while being watched by someone other than parents were often placed in unsafe sleep positions, a study has found.
Researchers examined more than 10,000 infant deaths from 2004 to 2014 and found that 1,375 cases (13.1%) occurred during the absence of a parent. They found infants who died of sleep-related causes under non-parental supervision were less likely to be placed in the “supine” position - lying horizontally with their face and torso facing up.
Among the babies who died under non-parental supervision, those supervised by relatives or friends were more often placed on an adult bed or couch for sleep and were more likely to have objects in their sleep environment. The researchers urged paediatricians to educate parents that all caregivers must always follow safe sleep practices.
“If someone else - a babysitter, relative, or friend - is taking care of your baby, please make sure they know to place your baby on the back in a crib and without any bedding,” said Dr. Rachel Moon of the University of Virginia School of Medicine.
Dr Moon added: “It’s always best to discuss where and how your baby should sleep. You can’t make assumptions that the person with whom your baby is staying will know what is safest.”
So if you’re leaving your baby with a family member or friend for the first time, what should you ensure they know before you leave the house?
Kate Holmes, support and information manager at The Lullaby Trust told HuffPost UK: “Whether caring for your own baby, or babysitting a friend or relative’s little one, it’s important that you’re aware of the risks of sudden infant death syndrome (SIDS). While SIDS is rare, it’s important that anyone taking care of an infant knows the safer sleep practices that reduce the chance of SIDS occurring.”
The Lullaby Trust advised that parent should make sure all babysitters are aware to:
:: Place the baby on his or her back.
:: Put the baby (if aged 0-6 months) to sleep in their own cot or Moses basket in the same room as where you are for both day and night-time sleeps.
:: Avoid letting the baby get too hot.
:: Don’t cover the baby’s face while sleeping or use loose bedding.
:: Keep cot as clear as possible, with no pillows, duvets, cot bumpers, soft toys or baby products.
The charity suggested parents could pass on their Easy Read cards that encourage safer sleep.
Pregnancy: Week By Week
This week begins with your menstrual bleeding or period. You are not pregnant yet. Cycle day 1 is the first day of menstrual bleeding. Ovulation and fertilization happen at the end of next week.
At the end of week 2, the sperm meets the egg on the day of ovulation in a process called fertilization. Pregnancy begins when the embryo implants, about 6-12 days after ovulation/fertilization.
The fertilized egg moves down through the fallopian tube towards the uterus. Implantation happens on average 9 days after ovulation/fertilization.
Week 4 is a very eventful week. The embryo will travel through the fallopian tube, arrive in the uterus and implant on average 9 days after fertilization/ovulation. And within days after implantation, the pregnancy test will be positive!
Now things are moving along quickly in the growth process. The blastocyst now consists of three layers. The innermost layer or endoderm is where the intestine, bladder, pancreas, and liver will form.
Your baby has grown from 1/17 of an inch to 1/3 of an inch. While your baby may still be very small, many of the crucial organs are developing rapidly. Arms and legs are growing, but fingers and toes have yet to sprout.
You are now more than halfway through the first trimester, and the baby continues to grow rapidly. Last week, baby measured 1/3 of an inch and now he has grown to 3/4 of an inch in length. The heart is beating and if an ultrasound is performed, a fluttering will be seen on screen.
Cartilage is now forming and bones are growing. Baby is forming the skeleton that he will use to stand, walk and run later in life. Eye structure is progressing and the tongue is beginning to develop. Intestines have formed in the umbilical cord, but are now moving out of the cord and into baby’s abdomen.
Growth has reached a crucial point by week 10 and you may see fetal movements on ultrasound. The movements are very small, but they are quite important. With joints fully developed, baby needs to move to ensure everything is working properly.
At the start of the 11th week, baby is now officially called a fetus. The most crucial development phases are concluding. The fetus now must concentrate on growing longer and larger during the next 29 weeks. Growth is fast now and the fetus will gain about one inch in length during the 11th week alone.
The 12th week starts a new day for the fetus. Growth speed is increasing exponentially and formed organs are starting to practice the functions they will have outside of the womb. The intestines, for example, start practicing peristalsis. Peristalsis is the muscle movement of the intestines that helps during digestion.
The 13th week concludes the first trimester. The alien look of an early fetus on ultrasound is disappearing as the eyes move closer together and the ears shift to their normal location. The gender could be viewed if an ultrasound could see that far into the womb.
Welcome to your 2nd trimester of pregnancy! At this point in growth, an ultrasound would show movement in the chest area. This movement is breathing practice. Hands and feet are moving now too, though most of the movements are reflex.
By the 15th week of pregnancy, some parents are itching to find out the sex of baby. In utero, the fetus may be sucking the thumb or fingers. The suck reflex is one of the most important instincts a baby has, because without the suck reflex, babies cannot breastfeed or bottle feed effectively.
By the start of the 4th month, pregnant women tend to start feeling movements in the abdomen. Intially, it may only feel like flutters but the fetal bones are hardening now so movements that have been occurring for weeks can now be felt.
The fetus is continuing to grow faster than ever before. All reflexes are in place so the fetus can suck, swallow and blink. The heart is pumping vigorously and can pump more than 25 quarts of blood on any given day.
Bowel development continues and the first bowel movement, meconium, is developing inside. Baby will not pass the first movement until after birth, in most cases. The fingers and toes are developing pads and soon fingerprints will form. The boy fetus is developing the prostate gland during week 18 of pregnancy.
Lanugo, or fine hair, has been growing on baby’s skin since the 15th to 16th week. During week 19, vernix caseosa starts to develop. Vernix caseosa is a thin white covering that protects the skin from the fluid environment of the amniotic sac.
The 20th week marks the halfway point for a normal pregnancy. Growth continues to add length and weigh to the baby. By the 20th week, baby can weigh more than one pound and measure 8 inches or longer. Fetal growth is determined by many factors, so baby may grow more quickly for some pregnant women and more slowly for others.
This week marks a slight slowing of the growth process. The fetus continues to grow, but more attention is paid to internal organs and development than weight gain. Length does not slow as rapidly, so the fetus may take on an extremely thin façade for a while. Male fetuses begin to drop the testes during week 21.
The fetal brain growth continues daily. The sense of smell, taste, sight, hearing, and touch are all developing as well. Baby can suck, swallow and hear. What is the fetus hearing? Heartbeats, breathing, and digestion. These sounds are like lullabies to the baby, which may be why babies tend to be more comfortable laying on mom’s tummy than dad’s tummy for a while after birth.
This week marks a huge milestone for the fetus. Development has reached the point that the fetus could conceivably survive if an early birth was required. The risk factors for impaired neonatal health are high, and survival, though very low, is a tangible reality. Baby will sleep and wake, though maybe not on the same cycle as mom.Week 24
Now the fetus is usually considered "viable" in the U.S. by most doctors. That means it has a reasonable chance of surviving if born prematurely. During the 24th week, the fetus continues to gain good weight. Weighing in at more than 1 1/3 pounds, your baby is gaining weight thanks to bone development, muscle growth, and organ growth.
The spine continues to strengthen in the 25th week of pregnancy. When complete, the spine will be made up of 1000 ligaments, 150 joints, and 33 rings. The process seems complicated, but the female body has all the instructions down pat. Lungs also continue to grow with blood vessel winding through lung tissue. The nostrils have been closed to this point, but now they start to open just a bit.
The fetus continues to grow rapidly and weighs about two pounds and measures nine inches or more by the 26th pregnancy week. The air sacs of the lungs are starting to develop and the surfactant is being secreted to line the air sacs. Surfactant is necessary for normal lung function. The brain is also working hard as hearing and vision are developing this week.
This is another huge landmark in pregnancy. It is the last week of the second trimester. The baby's brain is quickly developing and the lungs continue to prepare for breathing air once the baby is born. Eyelids open and retinas develop this week as well.
Welcome to your 3rd trimester! The 28th week of gestation is the start of the 7th month and the third trimester. The fetus is growing by leaps and bounds and has a 90% chance of survival if born during this week. The lungs can breathe air, though some development is still needed to fully function properly outside the womb. Body fat increases to 2-3% this week. Your baby can weigh more than two pounds by the end of the week.
The fetus is finally starting to look like a baby. The head and body are proportionate at this time. Weight gain is rapid as fat stores continue to build under the skin. Eyes are completely developed and are now sensitive to light. Fetuses are now able to hear, see and smell. Women that are pregnant with multiples have the same milestones this week though singlets may soon outweigh multiples.
Fetal growth continues and baby weighs three pounds or more and continues to gain weight daily. Bones have developed and bone marrow has started producing red blood cells. The white covering over the skin, lanugo, is starting to fade away in preparation for birth. Hearing has developed to the point that the fetus recognizes certain voices. Both mom and dad can talk to baby, sing and laugh. These sounds do not have to be directed at the belly for baby to hear.
Fetal growth is beginning to slow down a bit. As space tightens, the baby develops at a slower rate. All necessary body functions are working perfectly, time spent in the uterus at this point is all about lung development and weight gain.
All five senses are now in full working order. The fetus can see, taste, smell, feel and hear. Hair continues to grow, though some babies will be born with much more than others. Weight gain slows down a bit, especially for women pregnant with multiples. Between weeks 32 and 40, multiple fetuses will steadily gain less weight than singlets.
Amniotic fluid levels reach an all-time high. Fluid levels will remain the same until the baby is born. Fetal skin starts out red, but changes to pink in the latter weeks of pregnancy. The color change is attributed to fat distributions under the skin. More fat means pinker skin.
Brain development is rapid and thus the size of the head is growing to hold new brain tissue. Brain development accounts for the growth of about 3/8 of an inch each week.
The fetus weighs in at more than 5 ½ pounds by the 35th week. This number is just an average as some babies are born full term weighing only 5 1/2 pounds. There is very little room left in the uterus, so when baby moves the pregnant woman will feel it. It is common to visibly see movement through the skin of the abdomen from time to time including kicking, punching and rolling.
It's just four weeks to go until the due date. During the next few weeks, the weight of baby will shift downward relieving some of the shortness of breath associated with the upward growth of the uterus. While this can leave a pregnant woman feeling as if she has enough wind to run a marathon, the relief comes at a price. That marathon will be run to and from the bathroom. The downshift in weight leaves very little space for storage in the bladder. The baby continues to collect fat with dimpling starting on knees and elbows.
The 37th and 38th weeks of pregnancy are considered early term. Pregnant women who make it to the 37th week no longer have to worry about delivering the baby early. The fetus weighs around 6 1/2 pounds and practices breathing during every waking moment. An ultrasound will actually show fetal breathing movements which often confuses parents. Baby is not really breathing, as there is no air in the uterus.
If baby measures too large at an ultrasound in the 38th week, the doctor may choose to induce labor to protect the health of the pregnant woman and baby. Meconium is also developing in the bowel of the fetus. When the bag of waters breaks, it should be clear. If meconium appears in the amniotic fluid, you will be monitored more closely and labor will be sped along as quickly as possible.
Good things come to those who wait. And if you are scheduled for a cesarean section, either because you previously had a cesarean section or for other reasons, chances are that it will be done in the 39th or 40th pregnancy week or later.
Time is up! With 40 weeks of the pregnancy behind you, many pregnant women feel the time to have the baby is NOW! Predicting birth dates is an inexact science. There is a give of two weeks before and after the estimated date of birth. A pregnancy is not considered overdue until after the 42nd week. Rest assured, however, the baby is now fully-grown and ready to safely exist outside the womb.
By now, most pregnant women are ready to give birth. Fatigue, pain, swelling and abdominal weight alone are enough to keep women in bed until labor pains begin. For the fetus, week 41 is nothing more than an extended vacation. The fetus will continue to store fat and practice breathing throughout the 41st week. As long as the placenta is in good working order and amniotic fluid levels are good, the baby is fine.
In most pregnancies, the baby will have been born by the 42nd pregnancy week. With every passing day, the chance of having a vaginal birth diminishes, especially for pregnant women with narrow hips. If the baby has not moved into the birth canal, C-section may be the best option.