Cosme

Prep time: 40 minutes
Ingredients:

• 2 eggs, beaten with a fork
• 1 c. cornmeal
• 1 c. flour
• 1 c. milk
• 2 tsp. baking powder
• 1/4 c. vegetable oil
• 1 tsp. salt
• 1 tbsp. sugar
• 1/2 c. corn (fresh, canned, or frozen if it's taken out of the freezer ahead of time and soft)

Utensils:

• oven (You'll need help from your adult assistant.)
• fork
• large bowl
• mixing spoon
• square baking pan (8" x 8") coated with nonstick spray
• knife
• measuring cups and spoons

Directions:

1. Preheat oven to 400 degrees Fahrenheit (200 degrees Celsius).
2. Put all the ingredients, except for the corn, into a large bowl.
3. Beat all the ingredients together with a big wooden spoon. The mixture should be smooth.
4. Stir in the corn and mix.
5. Pour the mixture into baking pan coated with nonstick spray.
6. Bake in the oven for 25 or 30 minutes or until the cornbread is light brown on top.
7. Remove bread from the oven, cut it into 9 pieces with a knife, and serve it warm for a lip-smacking treat.

Serves: 9

Serving size: 1 piece

Nutritional analysis (per serving):

226 calories

5 g protein

7 g fat

30 g carbohydrate

1 g fiber

48 mg cholesterol

376 mg sodium

77 mg calcium
1.5 mg iron

Note: Nutritional analysis may vary depending on ingredient brands used.

• When you quit smoking, you may feel edgy and short-tempered.
• You may want to give up on tasks more quickly than usual.
• You may be less tolerant of others’ behavior.
• You may get into more arguments.

Did You Know?

• Studies have found that most quitters report increased feelings of irritability, anger, and frustration within a week of quitting.
• If feelings of irritability, anger, and frustration occur, they usually begin on the first day, peak during the first couple of weeks, and disappear within a month.

What To Do

• Take a walk.
• Exercise.
• Reduce caffeine.
• Soak in a hot bath.
• Read up on relaxation/meditation techniques and use one.
• Take one minute and, with your eyes closed, pay attention to your breathing pattern. Breathe in deeply through your nose and breathe out through your mouth.

Nicotine and Your Body and Mind

• When your body does not get nicotine, you may feel irritable, angry, and frustrated.
• Quitting will temporarily change your brain chemistry. These temporary changes may result in your experiencing negative emotions.

Related Notes

• Feelings of anger, irritability, and frustration may be reduced by using nicotine replacement products, which deliver small, steady doses of nicotine into the body. Nicotine replacement patches, gum, lozenges, nasal spray, and inhaler appear to be equally effective. Buproprion pills (which don’t contain nicotine) also help relieve withdrawal symptoms.

How To Get Help

• If you or someone you know wants help with giving up tobacco, please call the National Cancer Institute’s Smoking Quitline toll-free at 1–877–44U–QUIT (1–877–448–7848). The information specialists on the Quitline can provide suggestions and support to help smokers break the habit.
• The Federal Government’s Smokefree.gov Web site (http://www.smokefree.gov) allows you to choose the help that best fits your needs. You can get immediate assistance:
  • View an online step-by-step cessation guide.
  • Find state quitline telephone numbers.
  • Instant message an expert through NCI’s LiveHelp service.
  • Download, print, or order publications about quitting smoking.

What To Expect

After you quit smoking, handling the normal stresses in your life may become more of a challenge.

• Ouiting smoking itself is stressful and adds to your stress load.

Did You Know?

• Most smokers report that one reason they smoke is to handle stress.
• You may become more aware of stress during withdrawal. This happens because smoking cigarettes actually relieves some of your stress by releasing powerful chemicals in your brain.
• As you go longer without smoking, you will get better at handling stress, especially if you learn relaxation techniques.

Nicotine and Your Body and Mind

• Everyday worries, responsibilities, and hassles can all contribute to stress.
• It is thought that once nicotine enters your brain, it stimulates production of a number of the brain’s most powerful chemical messengers.
• These chemicals (epinephrine, norepinephrine, dopamine, arginine, vasopressin, beta-endorphin, and acetylcholine) are involved in alertness, pain reduction, learning, memory, pleasure, and the reduction of both anxiety and pain.
• When you smoke, your brain chemistry changes temporarily so that you experience decreased anxiety, enhanced pleasure, and alert relaxation. This is why it feels good when you smoke.

What To Do

• Know the causes of stress in your life (your job, your children, money).
• Identify the stress signals (headaches, nervousness, or trouble sleeping).
• Create peaceful times in your everyday schedule. (For example, set aside an hour where you can get away from other people and your usual environment.)
• Try new relaxation methods and stick with the best one for you.
• Rehearse and visualize your relaxation plan. Put your plan into action. Change your plan as needed.
• Seek and learn relaxation techniques such as progressive relaxation.

Related Notes

• You may find it helpful to visit your library or bookstore to pick up a book about how to handle stress.

How To Get Help

• If you or someone you know wants help with giving up tobacco, please call the National Cancer Institute’s Smoking Quitline toll-free at 1–877–44U–QUIT (1–877–448–7848). The information specialists on the Quitline can provide suggestions and support to help smokers break the habit.
• The Federal Government’s Smokefree.gov Web site (http://www.smokefree.gov) allows you to choose the help that best fits your needs. You can get immediate assistance:
  • View an online step-by-step cessation guide.
  • Find state quitline telephone numbers.
  • Instant message an expert through NCI’s LiveHelp service.
  • Download, print, or order publications about quitting smoking.

Prep time:

Ingredients:

• 2 ice cubes
• 1 c. milk
• 1/3 c. cottage cheese
• 2/3 c. frozen strawberries
• 1 1/2 tsp. sugar
• 1 tsp. vanilla extract

• blender (You'll need help from your adult assistant.)
• serving glass
• measuring cups and spoons

1. Pour all of the ingredients into the blender.
2. Put the lid on the blender and blend for 45 to 60 seconds until smooth.
3. Pour your smoothie into a glass and enjoy.

Serves: 1

Serving size: 1 large glass
Nurtritional analysis (per serving):

289 calories

19 g protein

2 g fat

49 g carbohydrate

3 g fiber

7 mg cholesterol

430 mg sodium

369 mg calcium
0.8 mg iron

Note: Nutritional analysis may vary depending on ingredient brands used.

Sometimes abnormal cells develop in the breast tissue, forming a lump or tumor. This is the most common type of cancer in women.

The breast has several lobes, which are divided into lobules and end in the milk glands. Tiny ducts run from the many tiny glands, connect together, and end in the nipple. Any tissue in the breast can be affected and it will destroy the nearby tissues also. Usually the cancer arises from tissue that forms milk ducts. There are at least 15 different kinds, depending on the site of development . Both women and men can develop breast cancer, but it is very rare in men.

Breast cancer occurs more commonly in the left breast than the right and more commonly in the outer upper quadrant. The tumor may distort the shape of the breast or the texture of the skin as it becomes larger. It can be detected when it grow large enough to either be felt or seen on a mammogram.

The cancer cells spread through the specialised channels in the breast called lymphatics to the lymph nodes to form tumors. It also spread or metasize to the other parts of the body through the blood stream. It spreads through the right side of the heart to the lungs, and eventually to the other breasts, the chest wall, liver, bone and brain. Spreading of the tumor to other parts of the body can cause death.

Breast cancer can be classified by histologic appearance and location of the lesion.

The bladder is a hollow organ in the lower abdomen (pelvis). It collects and stores urine, liquid waste produced by the kidneys. Urine passes from each kidney into the bladder through a tube called ureter and leaves the bladder through the urethra. The wall of the bladder has several layers. A layer of urothelial cells (also called transitional cells) lines the inside of the the kidney, ureter, bladder, and urethra. This layer is called the urothelium or transitional epithelium. Beneath the urothelium, there is a thin zone of connective tissue called the lamina propria. The next deeper layer is a wider zone of muscle tissue called muscularis propria. Beyond this muscle, another zone of fatty connective tissue separates the bladder from other nearby organs. As the cancer penetrates through these layers into the wall of the bladder, it becomes harder to treat.

Learn what you need to know about getting pregnant, prenatal care, maximizing your chances of conception by learning about ovulation, menstrual cycles, care during pregnancy - diet, exercise etc, Also know how your baby grows during pregnancy and some common problems that can occur with pregnancy.

Becoming Pregnant

• Female Reproductive System
  

• Menstrual cycle and ovulation

• Methods to know ovulation time (most fertile period)

• Maximising the chances of conception

• Planning a pregnancy

• Signs of pregnancy

• Tests to confirm pregnancy.

Planning

Some experts believe three months to be a perfectly adequate length of time to prepare for a pregnancy, others advise waiting six months or a year especially if you are recovering from any serious illness and have been prescribed drugs to treat it. Three months would be ideal normally as it takes at least eight weeks for eggs and sperm to develop to the stage of being ready to be released. Both partners should take care to be healthy to ensure that both the eggs and sperm developed are healthy. Keep fit, eat wisely, avoid things that could be harmful, and visit your doctor during this period. This way you can prepare for a normal pregnancy and a healthy baby.

Timing your pregnancy
The best time for a woman to have a baby is in her twenties. At this age her body is fully grown, there is no risk of damage to growing bones and she is supple and flexible with plenty of energy. As she grows older, particularly once she is past her early thirties, the more likely she is to experience complications. The older the mother the greater the risk of having a baby with abnormalities such as the down's syndrome which is related to increasing age.

Getting tested for infections and deficiencies:
Infections can harm both the mother and the fetus. Some infections during pregnancy can cause severe birth defects or illnesses in the fetus.
Rubella or German measles is one such infection which can have disastrous effects on the development of the babies vital organs if contracted during the first four months of pregnancy. A blood test can be done to check whether you are immune to the disease. If you are not, a vaccination can be taken for immunisation. But care should be taken not to get pregnant for the following three months after immunisation.

STD's or sexually Transmitted Diseases
Infections passed through sexual contact also are harmful during pregnancy. Apart from affecting your ability to become pregnant, these diseases can also infect babies in the uterus and cause harm. It is always better to get tested and treated if you feel there is a chance of contracting some form of STD. In case you suspect an HIV (Aids) infection, testing will help you decide whether to take the risk of getting pregnant at all.

Genetic disorders like sickle cell aneamia, thalassaemia, cystic fibrosis,muscular dystrophy or other types of aneamia which are inheritable should be tested before planning a pregnancy. Genetic counseling can be done to seek advise about the relative risk of passing the disorder on to the baby.

Toxoplasmosis
Toxoplasmosis infection, which is transmitted through cat feces and undercooked or raw meats, may adversely affect a fetus. There are often no symptoms of infection or only a mild flu like symptoms, so women who are at risk and are considering pregnancy can be tested for immunity prior to conception. All pregnant women should avoid or exercise caution in handling cats and consuming raw meats.

Listeria
Listeria in a pregnant woman causes miscarriage and stillbirth. Babies who are infected with the illness in the uterus rarely survive. Pregnant woman should avoid cook chill foods and readymade dishes found in cold cabinets in food stores such as scoop variety ice cream, soft cheeses, un-pasteurized diary products which are a source of listeria bacteria.
Chicken pox If a woman has not already had or been immunized against varicella (chicken pox), vaccination well before conception is highly recommended.
Anemia It is better to check if you are aneamic - deficient in iron before beginning a pregnancy.

Alcohol, Tobacco and Illegal Drugs
Alcohol, tobacco and illegal drugs can harm both you and your fetus. Smoking and drinking alcohol can damage both the developing sperm and man's fertility as well. If a woman uses these substances, there is an increased risk of miscarriage and problems such as mental retardation and birth defects in a baby. No amount of these substances has been proven safe to use during pregnancy.

Medications and Drugs
Consult your doctor about existing medical conditions such as diabetes, heart disease etc you may have and medications you are taking, prior to conception. All chemical substances affect the production and growth of cells in our bodies. Even sleeping pills and paon killers are better avoided at this stage. Improve your health
Both you and your partner should eat a healthy diet by taking more fruits and fruits and vegetables, whole grains and reducing high fat or sweet for at least three months prior to pregnancy. All women trying to conceive should get plenty of folic acid (found in green leafy vegetables and whole grains) in their diet as a deficiency of folic acid can lead to some birth defects like neural tube defects in developing infants. Take a multivitamin supplement that has 400 micrograms of folic acid and no more than 100% of the recommended daily allowance (RDA) of other nutrients. Vitamin B6 (whole complex B vitamin) is also beneficial.

Stop birth control methods
Stop using contraceptive pills several months before you try to conceive so you can have at least two normal cycles before succeeding. Remove an IUD before you begin trying. And since the risks of spermicides aren't really clear, you may want to use a condom or diaphragm alone for a month or so before you try to conceive.

Keep your environment safe.
Avoid exposure to X-rays, lead (which can be found mainly in hot tap water), fumes from paint or glue, hazards at work, secondhand smoke and pesticides.

Ovulation normally occurs fourteen days before beginning the next period, regardless of the length of the cycle. So a woman with a 28 day cycle would tend to ovulate on day 14. The woman with a 32 day cycle would tend to ovulate on day 18 (32-14). The life time of the egg is brief -only 24 hours. So to get pregnant the sperm should reach the egg during this fertility period.

Female reproductive system

Uterus is a pear shaped muscular organ about the size of a fist. It is designed to nourish and support the developing fetus. It can stretch to many times its size during pregnancy as the baby grows and contract its powerful muscles to begin the birth process.
The inner lining of the uterus, Endometrium is composed of blood enriched tissue which drops off or sheds each month during a menstrual period.

Uterus opens into two Fallopian tubes on the upper side as shown in figure. Fallopian tubes serve as the path way of egg from the ovary into the uterus as well as it is in the upper portion of one of these fallonpian tubes that fertilization (egg meets the sperm) takes place.

The two Ovaries on either side of the uterus store eggs and produce the female sex hormones, estrogen and progesterone which make reproduction possible. The process of ovulation, the release of a matured egg start from the ovaries.

The Cervix is the entrance to the uterus, also known as the womb. The Vagina is a soft, moist, elastic organ which connect cervix to the outside of the body. Sperm is released into the vagina during intercourse.

Normally every woman releases a ripened egg from one or other of her ovaries each month throughout her child-bearing years. On leaving her ovary, the egg is gently guided along the fallopian tube towards the uterus. During this time sperms produced by the male testes leave the penis up on ejaculation during intercourse. The sperms swims up through the cervix and the uterus to the entrance into the fallopian tubes. If the sperm and egg happen to meet in the fallopian tube, the two may become fused to create a single cell. This single cell then begins to divide, eventually implanting itself inthe lining on the uterus or womb, to start a pregnancy.

Menstruation cycle and Ovulation

The menstrual (monthly) cycle - the periodic uterine bleeding is one of the key physiological functions of the female body. Ovulation is release of a matured egg from the ovary. During ovulation if the egg does not get fertilized (does not meet the sperm), it disintegrates and is released along with the inner lining of the uterus, (endometrium) causing bleeding. This process is known as menses or menstrual period.

Menstrual cycle (Time between two periods) usually averages 28 days in length with normal variation ranging from 21 to 35 days. The day a period starts is counted as day 1 of the menstrual cycle. When the two -seven days of your period are over, the ovary begins ripening another egg ready for release during the next ovulation. Meanwhile the uterus begins to build up another inner lining ready to receive the fertilized egg.

Ovulation normally occurs fourteen days before beginning the next period, regardless of the length of the cycle. So a woman with a 28 day cycle would tend to ovulate on day 14. The woman with a 32 day cycle would tend to ovulate on day 18 (32-14). The life time of the egg is brief -only 24 hours. So to get pregnant the sperm should reach the egg during this fertility period.

Basal Body Temperature (BBT)

Basal Body Temperature chart is a way commonly used to determine the time of ovulation. The basal body temperature refers to the temperature of your body at rest. You will need a special thermometer or ovulation thermometer and graph papers or a special chart. To determine your BBT, record your temperature everyday upon awakening before you get out of bed. Immediately after ovulation there will be a slight (no more than 0.4 to 1.0 degree Fahrenheit) but definite rise in your body temperature. Temperatures remain elevated until the next menstrual period.

Prior to ovulation, a woman's basal body temperatures generally range from 97.0 to 97.5 degrees Fahrenheit. Temperatures are suppressed at this time due to the presence of the hormone estrogen. After ovulation, due to the production of the heat-inducing hormone progesterone, temperatures rise to about 97.6 to 98.6 F. This rise in temperature indicates that ovulation has occurred. Your most fertile day is the one immediately before the rise in temperature. This method can be best utilized along with other fertility signs such as a pain or ache felt on one side of the lower abdomen, to be accurate. When a woman is pregnant, her temperature remains elevated throughout pregnancy. This test can also be used to know whether a woman is ovulating or not. If ovulation does not occur the normal temperature remains static always.

Maximizing the chances of Conception

Each woman should have an idea about the menstrual cycle and the ovulation (most fertile period) to maximize the chances of conception. There are some natural methods available to find out your ovulation time. The fertile and infertile phases can be identified by the common Calendar (rhythm) method - by taking note of the length of your menstrual cycle, Temperature method - by observing basal (resting) body temperature and Cervical Mucus method (Billing's method)-noting the changes in woman's cervical fluid. This awareness can greatly optimize the chances for conceiving a child. But the reliability of all these methods depends on a woman having regular, predictable menstrual cycles with clear cut temperature and cervical mucous discharge patterns every month.

Once you know your most fertile period, it is better to avoid love-making for a couple of days before your anticipated fertile time. This increases the number of sperms in the semen, enhancing your chances of conception. After orgasm the sperm takes about 30 minutes to reach the fallopian tubes from the vagina. So the chances of conception are increased still further, if you remain lying down for at least thirty minutes after making love. The common man on top position during intercourse and keeping a pillow under your bottom, tilting your pelvis to allow full penetration gives a sperm a head start to the vagina and thus enhances conception.

Signs

The symptoms of pregnancy vary from woman to woman. Some experience a variety of symptoms and others experience none of the signs of pregnancy. Missing a period is the most obvious indication, but there are others which you may, or may not, experience

The early signs of pregnancy include:

• A missed period, or a rather scanty one.
  A missed period is usually one of the first indicators of pregnancy for women. However, some women experience spotting or a light menstrual-like flow, when implantation occurs (about 10 days after conception). The bleeding that occurs when the developing embryo becomes implanted into the uterine wall is lighter and shorter in duration than is menstrual bleeding.

• Breast Changes (Heaviness and tenderness)
  Many women feel an overall tenderness and heaviness of the breasts. The areola (nipple area) becomes more sensitive, sometimes painfully sensitive, and darkens. The breasts become more full and the veins often become more apparent. These changes begin as early as one week after conception.

• Nausea and sickness, or changing tastes
  Most pregnant women become sensitive to certain smell and experience nausea, vomiting etc. Some develop an aversion to certain things liked before. The intensity with which women experience morning sickness varies tremendously. This feeling may persist through the first trimester or longer.

• Increased frequency of urination
  Most women feel like emptying bladder more frequently than usual.

• Fatigue
  Fatigue and shortness of breath are common early in pregnancy. You may feel exhausted at the day's end, even when you haven't done anything out of the ordinary.

Tests

Blood or Urine tests and a pelvic exam are necessary to confirm pregnancy.

Urine Pregnancy Test
The most simple way to confirm pregnancy is to buy a pregnancy testing kit available in drus stores, two weeks after a missed period or earlier. It is based on the detection of pregnancy hormone in the urine. The first urine specimen of the day is preferred for testing as it has more concentration of pregnancy hormone. This test can be performed in a matter of few minutes and only one or two drops of urine is required. If the urine changes colour, the test is positive. The test result can show incorrect results. Occasionally a false - negative results can be a sign of ectopic (tubal) pregnancy.

Pelvic Exam
If the urine test is positive or if you have any symptoms of pregnancy even if the urine test is negative, you must consult a gynecologist. The doctor does the pelvic exam usually after six week from the last menstrual period, to confirm pregnancy. The physician inserts two fingers into the vagina alongside the cervix while the other hand presses the lower abdomen and directs the pelvic organs towards the examining fingers. The more relaxed your abdominal and vaginal muscles, the more comfortable and thorough will be the exam. The main purpose of pelvic exam in early pregnancy is to evaluate the size of the uterus, tubes and ovaries. The doctor determines how many weeks you have been pregnant by evaluating uterine enlargements, initially detectable about 4 weeks after conception. Besides uterine enlargement he also looks for two other findings indicative of pregnancy, uterine softening and a slight bluish colourisation of the cervix.

Blood Pregnancy test
Blood pregnancy test are the costliest as well as the most sensitive and reliable of pregnancy tests. The basic type is called the radioimmunoassay (RIA) or beta subunit HCG. This test is often reserved for pregnancy complications such as a suspected tubal pregnancy, but it can also be used to determine if a woman is pregnant before the missed period. A blood sample is taken and the test result usually take about one hour. This test can also establish approximately how far your pregnancy has progressed in weeks.

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A nutritious diet with enough proteins, fats, carbohydrates, minerals and vitamins are essential during pregnancy. Your diet should consist of a variety of foods selected from the five basic food groups. Fresh fruits and vegetables, whole grain products like breads or cereals, meat, fish or other protein alternatives, milk and other diary products etc provide a nutritious diet. Keep off canned and processed foods, spicy foods, coffee, tea, hot chocolate, sugary foods such as cakes, cookies, candies, sodas and colas and reduce your salt intake as far as possible.

Eat as wide a variety of food as possible but in moderation. Too much of any one food can even be harmful if it leads to excessive gain in weight. Try to have three meals every day, or six smaller meals if you have problems with nausea or heartburn. A total up to a total of 2,200 or 2,800 calories is essential for a healthy pregnancy. Besides the natural diet, prenatal vitamins especially iron, calcium, folic acid are often prescribed routinely through out the pregnancy by the doctor.

Some of the essential nutrients

Folic acid: Folic acid is the most vital nutrient pregnant women need. This is needed for the development of baby's nervous system, especially in the first few weeks. Folic acid is a B vitamin that helps prevent neural tube defects (defects of the spine, brain, or their coverings) and other birth defects like cleft lip and congenital heart disease. By consuming at least 4 milligrams (mg) of folic acid every day before getting pregnant and during the first three months of pregnancy, you can help reduce the risk of these defects. Folic acid is found in dark-green leafy vegetables (like spinach or kale), liver, yeast, beans and citrus fruits, and in fortified cereals and bread. Folic acid is easily lost while cooking, so steam green vegetables or eat them raw.

Calcium : This is vital for the healthy development of your baby's bones and teeth, which start to form at about week eight. You will need about double the quantity of calcium than is normal. At least three servings of milk, yogurt, or cheese is essential to meet expectant mother's calcium needs. Apart from diary products, good sources include leafy, green vegetables. Diary products are also high in fat, so if possible choose low fat varieties such as skim milk. The recommended daily amount of calcium during pregnancy and breast feeding increases significantly from 800-1200mg.

Protein : Try to eat a variety of protein rich foods, because your needs increase during pregnancy. Vitamin B6 is needed for the proper utilization of protein. Fish, meat, nuts, peas, beans and diary foods such as milk and eggs all supply protein, but animal sources can also be high in fat, so limit your intake of these and choose lean cuts of meat whenever possible.

Vitamin C : This will help to build a strong placenta, enable your body to resist infection and aid the absorption of iron. It is found in fresh fruit and vegetables and supplies of the vitamin are needed daily because it cannot be restored in the body. A lot of vitamin C is lost by prolonged storage and cooking, so eat fresh produce and steam green vegetables or eat them raw.

Fiber : This should form a large part of your daily diet, since constipation and piles are common in pregnancy and fiber will help prevent it. Besides rich sources like fruits and vegetables, brown rice, nuts, cereals including oats, beans, peas and pulses etc are good sources of fiber.

Water: Water plays a key role in your diet during pregnancy. It carries the nutrients from the foods you eat to your baby, and also helps prevent constipation, hemorrhoids, excessive swelling, and urinary tract or bladder infections. Most importantly, drinking enough water, especially in your last trimester, prevents you from becoming dehydrated which can then lead you to have contractions and premature, or early labor. Pregnant women should drink at least six to eight glasses of water per day. You can drink juices for fluid, but they also have a lot of calories and can cause you to gain extra weight. Coffee, soft drinks, and teas cannot count towards the total amount of fluid you need as they have caffeine which actually reduce the amount of fluid in your body.

First Trimester

The development of the fetus and the changes in the expectant mother

The first trimester of pregnancy constitutes the first 12 weeks and it is the time when your pregnancy becomes established in your body. During the first trimester, your body is undergoing many changes. During this time the fetus makes its greatest developmental strides. Most of the physical and mental growth of the baby takes place during this time. The principal organs both external and internal, including the head, brain, heart, body and limbs and the nervous system of the baby form within this period. Fingers and toes are recognizable. Sex organs begin to develop but cannot yet be observed.

First Month

• This period ends with the fertilized egg's implantation within the lining of the uterus. The ovum's outer layers are forming the placenta, which is starting to develop a blood supply from your blood vessels. The inner cells are beginning to form into three layers. The umbilical cord, which carries nourishment to and waste away from your baby, is developing. At the end of your first month, your baby (known as an embryo) is only about the size of a grain of rice.

Second Month

• Your baby (now known as a fetus instead of an embryo) continues to grow and is floating in a fluid filled amniotic sac (a double layer of membranes). The principal organs in a simple form and thenervous system are formed. The heart has been beating since week 6 and is pumping blood around the embryo and out along the umbilical cord to the placenta. The site of the ears is evident and the eyes are developing and have some colour. The face is recognizable and there is a mouth and tongue. The limbs are changing from simple flippers and have elbow and knee joints; the hands and feet take shape with the beginning of fingers and toes. Organs like the stomach and liver are developing. There is a blood stream obtaining food from the rich lining of the uterus. At the end of the second month, the baby is about 1inch (2.5cm).

Third Month

• Your baby is now about three inches long and weighs about one ounce. By the end of third month, all the major internal organs - the heart, lungs, kidneys, liver and stomach have been formed and are working. The embryo has ears, a nose and recognizably male or female external genital organs. Her kidneys are functioning, producing urine that's passed into the amniotic fluid and eventually removed through the placenta. He also swallows amniotic fluid (cleansed and replaced every 24 hours by the placenta) helping the lungs to develop. The eyelids have formed and closed over the eyes which are continuing to develop. Nails are growing on well formed fingers and toes. The embryo is now quite active and moving freely. He can curl and fan his toes, squint, frown and open his mouth. Most of the time he is in a curled up position with his chin down and knees drawn up.

Mother's physical changes
You may experience some of the early signs of pregnancy such as missed periods, breast changes ( enlargement or tenderness), nausea, vomiting (morning sickness), increased frequency of urination, fatigue, slight weight gain, abdominal enlargement. Since the hormones of pregnancy slow digestion, some women tend to become constipated. Increased sweating is common. It is important to understand that these are all normal events and that most of these discomforts will go away as your pregnancy progresses.

During your pregnancy, you might feel tired even when you've had a lot of sleep at night. Many women find they're exhausted in the first trimester. Try to get eight hours of sleep every night. If you feel stressed, try to relax. Nausea and vomiting, usually called 'morning sickness' are common in the early stages of pregnancy. Avoid fatty and spicy and fried food. Eat frequent, small meals rather than 3 large meals. If you are vomiting a lot, make sure you don't get dehydrated. When the nausea and vomiting begins to go away, try to resume a healthy eating plan, and take your prenatal vitamins. While morning sickness causes some women to lose appetite and shudder at the thought of food, many other women finds their discomforts being eased off and they begin to have an increased appetite by the third month.

Dizziness, feeling lightheaded, and even fainting can occur at any stage of pregnancy, since there now is extra blood going down towards your uterus and legs.

Second Trimester

Second Trimester (13-28 weeks) is the most enjoyable time by the pregnant women as they find this time is more easier than the first trimester. During this period, many of the early symptoms of pregnancy like morning sickness and fatigue may usually disappear. You and your baby is undergoing many changes. At this stage the fetus is fully formed and look like a human. All the organs start growing and the baby started moving inside. By the end of the fifth month of pregnancy, you will start to feel the movement of your baby known as quickening. From fifth month onwards, the brain will undergo its most important period of growth. Your abdomen will start expanding and you will look like a pregnant women. At the second half of the pregnancy there may appear stretch marks which may be in pink, red, black in colour depending on the colour of your skin.

Fourth Month
At this stage, the fetus is fully formed and looks much more human although his head is still large in proportion to body. Now the baby is far less likely to be harmed by infections or other drugs. All the organs will start growing and improving their activities. The muscles are developing, so the baby moves much more. The kidneys are producing urine which is discharged from time to time into the aminotic fluid. Aminotic fluid is also continually added to by seepage through the surface of the placenta and from the fetal surfaces. The fetus swallows the fluid which is absorbed through his intestine. The fluid is thus being changed continually. The fetus is now practicing breathing movements. A thin, transparent and downy air called lanugo begins to cover him. His eyelashes and eyebrows is forming and has a bridge to his nose. Teeth are beginning to form in his gums and finger and toe nails are more definite. The baby has vocal cords and taste buds and can now suck her thumb. The heart is beating about 120 to 160 beats a minute. By the end of this month he weighs 140 gms (approx) and measures about 15-17 cm.

Fifth Month
This is a period of tremendous growth for your baby. The fetus is fully active and you should have felt his movements for the first time as a faint fluttering. He may even react to noises outside the womb. Your baby may suck its thumb. At the time of an ultra sound scanning, you may able to see the the moving of the baby. He has well - developed lanugo hair over his boy as well as hair appearing on the head. Fat is now being stored beneath your baby's skin. The sense of touch is developed at 17 weeks so it is able to feel its surroundings. By this month, baby's middle ear structures have formed, enabling baby to hear sound. Milk teeth will begin forming under your baby's gums. A greasy white substance called vernix caseosa coats her entire body to protect her skin during its long submersion in amniotic fluid. The blood cells take over for the liver the job of producing blood. At the end of the fifth month of pregnancy your baby is approximately 10-12 inches long and weighs about 340 gm.

6th month
This month is also considered as a period of rapid growth of baby. Now the baby is fully formed and looks like a miniature human. Your baby's skin seems wrinkled and red. The circulation of the lungs is forming. There have been dramatic development in the thinking part of the brain. His eyes are open which are usually blue in colour and will not change to their final colour until some weeks after the baby is born. Fatty sheaths which transmit electrical impulses along nerves are forming. Meconium, your baby’s first stool, is developing. Baby girls will develop eggs in their ovaries during this month. The baby's bones are becoming stronger. A special type of fat is forming to keep your baby warm at birth. You can feel the baby move if you put your hands on your stomach. You may even see shape of a foot or bottom as the baby turns and kicks. By the end of the sixth month, Your, baby will be around 11 to 14 inches long and will weigh about 900 gm. He has a good chance of survival if he should be born now and looked after in a special care baby unit.

Mother's Physical Changes
During the middle months of pregnancy, the expectant mother will probably feel better that she felt in the first trimester. Most of them will enjoy this time. She may be able to feel the movement of the fetus known as quickening. Morning sickness like nausea and fatigue usually lessen or disappear. You may started gaining weight rapidly. As the baby’s growth continues, the expectant mother’s uterus expands into the abdominal cavity. By the end of the fifth month of pregnancy, the top of the uterus, called the fundus, reaches the navel.

The expectant mother may see a yellowish fluid from her breast before breast milk. This is the best time to prepare for breast feeding. Indigestion problems like heartburn, gas and constipation may appear during this time. You may feel shortness of breath as your baby gets bigger, there will be increased pressure on all your organs especially in lungs. Increased sweating may be common. The skin on the abdomen and breast stretches and stretch mark may visible. A dark line will also form from naval down to the middle of the abdomen. Due to the increase in hormone, she may have nose bleeding and her gums may become more spongy and bleed easily.

Although miscarriage in low-risk pregnancies is rare at this time, women sometimes have other problems in the second trimester, including high blood pressure, which may be a sign of preeclampsia sugar in the urine, a sign of gestational diabetes (a form of diabetes associated with pregnancy), iron-deficiency (anemia) etc. You may notice a white-colored vaginal discharge called leukorrhea. It is normal but a colored or bloody discharge may be a signal of possible complications and should be examined immediately.

Take enough iron and other minerals because during your pregnancy, you body needs more iron for developing baby and the placenta and also to keep up with your expanding blood volume. Have iron rich foods which include, lean red meat, fish, lentils, legumes, spinach etc. Eating well with all the nutrients is very important for this time as your baby is also growing much more rapidly. There is a chance of getting a urinary tract infection may increase. Drink at least eight glasses of water each day. Most of the women may find difficulty in sleeping. Try using extra pillows to get comfortable at night. Put one between your legs as you lie on your side and another one behind your back.

During the regular check ups, the physician will check the height and weight of mother, the fetal heartbeat, the size, shape and height of the uterus, any swelling of the mother's hands and feet, blood pressure, urine and any other symptoms or discomforts depending on your medical condition.

Trimester

The third trimester (7th month- delivery) is the most important period for mother and child. Weeks of waiting and wondering will finally culminate with in short period. You may be anticipating the birth of your baby with pleasure, excitement and anxiety, which can be described as a nameless feeling of bud, which is waiting for blossom. It might be hard for you to believe that in a few short months you will be holding a new baby in your arms. You will have physical changes as the baby develops and grows in the womb and emotional changes as the idea of a new life becomes real. But at the same time, this time feel more uncomfortable for you because of this physical and emotional changes. The fetus grows rapidly during the last three months, multiplying its weight about three to four times. Usually the third trimester is the best time for preparing for your delivery. During this time your abdomen is very large and firm. You can see the movements of your baby clearly. By the end of the ninth month the baby is probably in the head first position in preparation for the delivery.

Seventh Month
During the seventh month, the baby is growing and gaining weight, so there is less space in your uterus and the aminotic fluid will start diminishing. This may affect the movement of the fetus and hence you might not feel the movement and kicks as much as you felt during the second trimester. It is during this last three months that a fetus grows most. During this time the baby will respond actively to the sound and touch. You can feel your baby's arms and legs if you watch your abdomen. His skin becomes thicker but smoother and will be covered with a white coating called vernix'. This protects your baby's skin as he floats in the amniotic fluid, preventing his skin becoming prune-like during his 9-month bath. Babies are actually asleep for most of their time in the womb. Baby can open his eyes and used to suck his thumb and cry. He loses most of the downy hair known as lanugo from his body. By the end of this month he weighs1.6 kg (approx) and measures about 40-42 cm. His lungs, heart control and digestive system is immature now and there is a good chance of survival with expert pediatric care if the baby born now2 .

Eighth Month
During this month, the fetus is too big to move around but it is possible for him to kick strongly and roll around. At this stage, many baby's, especially first baby's head will probably have descended into the mother's pelvis, ready for the birth. His brain is growing rapidly, and most of the internal systems are well developed except lungs. The brain and nerves started directing bodily functions. You can feel the baby's elbow or heel through your abdomen. At present the head bones are soft and flexible to make it easier for baby to fit through the birth canal. Nerve ending of your baby's ears are get connected now and it is possible for him to hear distinct sounds. If you are having a boy, his testicles have dropped from his abdomen where they will then descend into his scrotum. A layer of fat is forming underneath the thin, thus the skin will become less wrinkled, transparent and glowing. Soft nails have grown to the tips of his fingers and toes. Baby is practicing opening his eyes and breathing. The baby will gain about 28 gm every day for the remaining four weeks in the womb. By the end of this month your baby may weigh 2.5kg and measures about 46cm (18 inch).

Ninth Month & Beyond
This is the average time for a baby to be ready to be born. Baby's lungs are mature and ready to start their function. His brain is still be developing rapidly. During this month, baby gains about 1 kg. Usually baby will be in head down position and rests in the mother's lower abdomen. Some vernix will usually left on your baby, and it may still have some lanugo on its shoulder, arms and legs. A dark tar- like substance called meconium gathers in the baby's intestines; this will be passed in his first bowel movements after birth. His immune system is still immature, so he is receiving antibodies through the placenta, and after he is born he will get antibodies through your colostrum and milk. His fingernails may be so sharp that he scratches himself with them. By this time, your baby may weigh 2.5kg and measures about 46cm (18 inch).

Changes in Mother
At this final count down, you may experience various doubt and fear mixed with exhilaration. You are longing for the pregnancy to be over. Your body's ungainly proportions don't help your mood either. You will have a feeling of heaviness in your lower abdomen. At the beginning of the third trimester, as the baby grows larger, he presses on your internal organs and it may lead to the problems such as breathlessness, heartburn etc but once the baby's head drops into pelvis most of these problems will get reduced. On the other hand, your bladder will be under more pressure, so you may need to urinate even more frequently. Back aches, muscle cramps, and swelling of the hands and feet are quite common.

In the final two week. your pelvic joints expand for the birth, so you may have some discomfort in this area. With that your cervix will be softening in preparation for the labour. You will experience vigorous fetal movements, sometimes visible even through clothing. You may not get any comfort sleep because lying on your back makes you breathless. Sleeping on the left side by holding the upper leg and abdomen on pillows is quite helpful. Your navel will have flattened or even popped out.

There will be an increase in body temperature as the fetus radiates body heat which cause the mother feel hot. Swelling of the ankles, hands, and face may occur (called edema), as the mother continues to retain fluids. Colustrum, a fluid in the breasts that nourishes the baby until the breast milk becomes available, may leak from the nipples. Also breasts feel full, and bluish veins appear beneath the skin. A supportive bra will help relieve discomfort. More stretch mark will be appear on the abdomen, thighs and buttocks.

Towards the end of the pregnancy, noticeable contraction of the uterus, called Braxton Hicks contractions, increase in frequency. These contractions, which have occurred intermittently throughout pregnancy.

Sexual interest may decrease as both partners feel overwhelmed by the size of the pregnancy and the mother becomes increasingly tired and uncomfortable.

At the beginning of the third trimester, your physician will insist you to have prenatal visit once in every two weeks and by the end of the eighth month, your prenatal visits may be scheduled to every week. It will depend on the medical condition of the expectant mother and development of the baby. Your health care provider will continue to monitor your blood pressure and weight, as well as the activity and movements of the fetus.

Pregnancy is a unique experience for every woman. Your sensations may vary from those of your friends who are at the same point in pregnancy. It is better to ask to your friends, relatives or even from your mother about their experiences during pregnancy and share yours.

Acne

It is a common inflammatory skin disesase that mainly affects the face, neck, chest and upper back. it is caused by an interaction between hormones, bacteria and sebum produced by the comedones (pimples), pustiles (lesions filled with pus) and occasionally CYSTS. This is possibly caused by changing hormone levels.

Mild cases may be eased by washing the face with a gentle toilet soap or by drying agents such as benzoyl peroxide. Severe acne may need oral treatment with antibiotics such as tetracycline or hormone therapy such as Dianette, which also acts as a Contraceptive.

Very severe acne can be treated using a derivative of Vitamin A, called tretinoin or Retin A. This cream is applied in each night and takes about 3 weeks to be effective. An oral version called Ro- accutane is very good against severe acne but carries serious risks of foetal abnormality during pregnancy.

Amenorrhoea (Absence of periods)

It is a failure to have periods, which may be described as primary or secondary . Primary amenorrhoea is the failure to menstruate by age 16, and the main cause is the late onset of puberty. A girl may have the other signs of puberty but lack of periods. this may be a cause of a pituitary tumor, which can be found via a skull X -ray , or because of cryptomenorrohea, where menstrual bleedings does occur but it is held inside the vagina by an obstruction such as imperforate Hymen. The condition may arise because parts of the female reproductive system are missing. The most common reason for primary amenorrhoea is disruption of the relationship between the ovaries and the pituitary gland.

Secondary amenorrhoea occurs when a woman stops menstruating for 3 months or more after normal menstrual periods have been established but before the onset of the Menopause. It may arise as a result of stress, chronic diseases. Stopping the contraceptive pill, which affects hormone production in the brain , can cause amenorrhoea for up to a year, and it may arise after child birth and breast feeding. Failure of ovaries, prompting a premature menopause before the age of 40, is another cause. Amenorrhoea is permanent after the menopause or if the uterus is removed in a Hysterectomy

Leucorrhoea

A discharge of white-yellow coloured mucus from the vagina. it may be normal condition, increasing before and after menstruation, but a copious vaginal discharge, especially if it has a strong smell, probably indicates an infection in the genital tract. A common cause is thrush, but it may also be because of Gonorrhoea or some other sexually transmitted disease.

Osteoporosis

A condition in which the amount of bone mass decreases to the point where the bones are fragile and easily fractured, affecting twice as many women as men. Women are particularly risk from the osteoporosis as they have a lower density of bone, because of smaller body size than men. The risk increases those who have a premature menopause, early hysterectomy, previous anorexia nervosa etc. Also women who smoke or drink excessively are at the greater risk. Weight-bearing exercise , a diet rich in calcium, Vitamin D and other minerals, and not smoking can help to prevent bone loss. Hormone replacement therapy is the most effective preventive treatment but is not suitable for all women. Physiotherapy and acupunture can help to relieve pain. Osteoporosis can be detected by doing Bone Density Test

Pelvic Inflammatory Disease (PID)

It is an inflammation of the Fallopian Tubes, ovaries and Uterus. The disease can be acute or chronic. Acute PID causes severe abdominal pains, high fever , chills, foul-smelling vaginal discharge and abdominal tenderness. PID is a result of bacterial infection, but chlamydia and Gonorrhoea are responsible for mini cases. Treatment is by means of antibiotics and bed rest. The condition usually improve within two weeks. But if not, another antibiotics is given. If 3 courses of antibiotics do not clear the infection, then the disease is deemed to have become chronic, Chronic PID results in a low level of infection that can continue for weeks or months.

Symptoms are persistent abdominal pain or cramps, fatigue, weakness and very heavy menstrual periods. Some mild cases have few or no symptoms but can cause partial or total infertility.

Gonorrhoea

It is an extremely common venereal or sexually transmitted disease, that is caused by the bacterium Neissera-gonorrhoeae. The bacteria are found in the Mucous Membrances of the Vagina, Urethra, throat and mouth. If gonorrhoea is not treated it can damage and inflame the Fallopian Tubes and other pelvic organs, and this can arise after only 8-10 weeks. Other possible damage includes eye infection that can cause blindness, septicaemia (blood poisoning), Gonococcal Arthritis, it may occur in conjunction with a painful skin rash and inflammation of heart valves. Symptoms of gonorrheoa include vaginal discharge (green or yellow in colour), Dysuria, possible inflammation of the rectum and a sore throat . To diagnose the disease, swabs of the discharge are obtained and organisms grown are identified in the laboratory. Treatment is by a single , very large dose of penicillin, or tetracycline if the organisms is resistant to penicillin.

Mastitis inflammation of the breast

It occurs usually because of bacterial infection during breast feeding. Symptoms include, pain in the affected breast, tenderness, swelling, fever and possibly a chill. Treatment with warm compress and antibiotics normally resolves the condition. If the inflammation does not subside then a breast abscess may form.

Menorrhagia

It is menstruation with abnormally heavy or prolonged blood flow. This may be frequent periods, one that continuous for 7 days or more, or one with exceptionally heavy flow over two to three days. Menorrhagia can occur because of fibroids, inflammation in the pelvic cavity, an Intrauterine device (IUD) or hormonal imbalance.

The bleeding can cause anaemia with pallor fatigue, which can be treated with iron supplements. Treatment depends on the cause and may include a D and C, the combined contraceptive pill, removal of an IUD, or danazol, a drug that inhibits the hormones produced by the pituitary gland.