Infertility:-

The world health organization has defined sub fertility as the inability to achieve a pregnancy after 1 year of unprotected intercourse. The term infertile strictly speaking, should not be used until it is proved that pregnancy is impossible.
Now a day most of the couples decide to start their families later in life but increasing age reduces infertility and the time available for child bearing.

Causes of male Infertility:-

* hypothalamus dysfunction
* pituitary dysfunction
* adrenals dysfunction
* thyroid dysfunction
* celiac disease
* renal failure
* diabetes mellitus
*  testicular disorders.
* trauma
* environmental causes
* defective transport
* obstruction or absence of seminal ducts.
* congenital anomalies.
* infection or metabolic disorders.
* ineffective delivery
* psychosexual problems
* physical disability

Causes of female infertility:-

* endocrine disorders.
* hypothalamus dysfunction
* pituitary dysfunction
* adrenals dysfunction
* thyroid dysfunction
* diabetes mellitus
* celiac disease
* renal failure
* obesity
* strict dieting.
* ovarian disorders
* hormonal
* ovarian tumors.
* polycystic ovary disease.
* ovarian endometriosis.

Defective transport of Ovum:

* tubal obstruction:
* infection
* previous tubal surgery.
* previous surgery.
* endometriosis.
* cervical trauma
* congenital anomaly
* cervical trauma

Defective implantation:

* hormonal imbalance
* congenital anomalies
* fibroid.

The duration of pregnancy in human beings is around 280 days.
FERTILIZATION:-

fertilization is a process of union of male and female gametes to form zygote. This generally occurs at the outer end of the fallopian tube. After the sexual act, sperms travel towards the uterus and enter the fallopian tube . the ova released from the mature griffin follicle is taken up by the fimbrial end of fallopian tube. Ova meet the sperms in the fallopian tube. A single sperm enters the ova to fertilize it. Ovum survives in the genital tract for 24hours and the sperm for 72 hours.

ZYGOTE:-
The fertilized ovum is called zygote.  Zygote has 46 chromosomes. It undergoes repeated division and forms a morula.  Morula moves through the tube and gets implanted in the cavity of he uterus. The morula touches the endometrium of the uterus to form a blastocyst by about 5Th day after fertilization.

Structure of cell:-

The structure we visualize through electron microscope is known as ultra structure. The cell consists of the main parts such as , the cell membrane, cytoplasm, and nucleus.

Cells vary in their size and shape. Different organisms have different structures. Bacterial cells are spherical, yeast cells are oval, euglena have spindle shape, and amoeba have irregular structure. Size of a cell varies from a few microns to several millimeters.

Cell membrane:-
The cell is covered by a thin membrane is called cell membrane or plasma membrane. Both plant and animal cells consists of cell membrane. The cell membrane allows only certain materials to pass in and out of the cell. Therefore it is known as semi permeable membrane. Cell membrane also maintains the shape of the cell.

Following are the forces which bring about the movement of material in and out of the cell membrane.

Diffusion:- it is a physical process where a random movement of molecules from a region of higher concentration to lower concentration. The difference in the concentration is known as concentration gradient.

Osmosis :- it is a special type of diffusion. It involves the movement of water molecules from the region of higher concentration to a region of lower concentration through a semi permeable membrane.

Cytoplasm :- cytoplasm is gel like material inside the cell membrane. Cytoplasm contains a large amount of water and many chemical substances. The different structures of cells are suspended in the cytoplasm.

The structure inside the cell are called as organelles. These are of two types.

• membranous organelles.

• non membranous organelles.

Membranous organelles:  these organelles composed of membrane.

Endoplasmic reticulum:- it is a cytoplasmic structure which provides network inside the cell. It extends from plasma membrane to the nucleus. The rough endoplasmic reticulum contains ribosomes on it’s surface. It helps in transport of substance from one part of the cell to other.

Golgi complex :-  it is a bag like organelle having a number of flattened membranous structures placed one above the other. Exact function of golgi complex is unknown, but believed as it involved in secretion of chemicals.

The WHO expert committee on prevention of coronary artery disease proposed a comprehensive plan for the primary prevention of cad.

The principles of preventing cardiac disease are as follows:-

- altering the life styles and environmental characteristics: under this strategy, the aim is to reduce the risk factors in population. To achieve this all section of the community is essential. government should take action and need to make policies to prevent cardiac diseases. voluntary organizations, medical and nursing professionals, should create health awareness in people.

What do we need to prevent coronary artery diseases?

-we need to change our life styles and habits. our health is very valuable, and health is wealth. Necessary life style modifications are as follows.

- Avoid excess consuming of fatty foods.
- Maximally reduce the smoking habit.
- If you are smoking 20 cigars per day reduce it to 10 in next week. At the month end you should manage by 1 or 2 cigars a day. If you give up cigar immediately, it might be very difficult for you. So chronically reduce the number of cigars and one day you can drop it completely. Within a month or two month you can give up cigars easily. If it becomes very difficult, you can go for chewing gum, mints for some days. Try this and have good health.

Nerve muscles:-

Nerves and muscles are called as excitable cells. Neuron is the structural and functional unit of nervous system. The structure of neuron consists of the cell body and axon along with dendrites. The cell body consists of nucleus endoplasmic reticulum, ribosomes and Golgi complex. The cell body consists of nicely granules or frigid cells. They are present all over the cell except axon hillock. It resembles ribosomes and helps in synthesis of proteins. They disappear when nerve is damaged. The process is termed as Chromatolysis.

Dendrities:  They are short branching processes 5 to 7 in number. They carry information towards cell.

Axon: It is the long process of neuron. It arises from the prominent portion of the cell body called axon hillock. Axon carries information away from cells the axon is covered with myelin sheath. The cells of schwann form the myelin sheath. The process of myelin sheath is myelinogenesis. The myelin sheath is interrupted at periodic interval called the nodes of ranvier.

Nerve injury:-

Neurons do not multiply during life. Fortunately injury to a peripheral nerve fiber does not kill the neuron and various types of repair are possible. there are three types of nerve injuries:

1. Neuropraxia : there only pressure on the axon causing local anoxia. Recovery is possible within a few minutes to few days.

2. Axonotmesis: in this type of injury axon’s divided but the endoneurial sheath is continuous. This is due to prolonged and severe pressure on a part of neuron. Regeneration possible in this type of injury.

3. Neurotmesis: in this injury the axon and endoneurial tube are divided. Regeneration is complex. It depends on the endoneurial tube. If alignment restored regeneration is possible.

Blood Cell:-

As one of the important body fluid, blood is a fluid connective tissue present in the circulatory system. the presence hemoglobin gives red color to blood.
blood made up of fluid component plasmas 55%, and formed elements -

* Erythrocytes or RBC

* Leukosis or WBC

* Platelets and thrombocytes.

The PH of blood is 7.35 -7.42, the specific gravity is 1055 to 1060.

Functions of blood:-

1. Transport of oxygen from lungs to tissue site. and carrying carbon dioxide from tissues to lungs.

2. Supply of various nutrients to tissues. carrying of waste material s for excretion.

3. Transport of hormones, vitamins, drugs and chemicals.

4. Maintains acid- base balance.

5. Regulation of body temperature.

6. The immune system of blood protects against infection.

7. Helps in clotting of blood.

The total volume of blood is around 5 lit in an average adult male.

Plasma:-

Plasma is the fluid portion of blood. Its normal volume is 3500 ml. it is mainly composed of water.

Other substances:-

Inorganic substances : Sodium, potassium, calcium ions and copper.

organic substances: Proteins, lipids, glucose, urea and creatinine.

Serum is plasma without clotting factors.

Plasma Proteins:-

They are the proteins present in the plasma. Most of the plasma proteins are synthesized in the liver.

important plasma proteins are:

* Albumin
* Globulin
* Fibrinogen
* Prothrombin

Albumin: it has molecular weight of 66,000. it is produced in liver. Plasma half life of albumin is 19 days. it maintains the colloidal atmospheric pressure. it helps in transport of bilirubin, hormones and drugs.

Globulin: it helps in the transportation of proteins and immunoglobulin. it consists of:-
1. Alpha globulin
2. beta globulin
3. Gama globulin.

Fibrinogen: It helps in blood coagulation. Total proteins in the plasma are:-
albumin 6-8gms/dl
globulin 4.5-5.5 gm/dl
fibrinogen 0.2-0.4gms/dl
prothrombin 0.1gm/dl
albumin globulin ratio 1:7:1

Prothrombin:  Prothrombin is inactive precursor of thrombin. Its concentration in plasma is 15 mg/dl. It is formed in the liver with the help of vitamin k.

Functions of plasma protein:-

* It maintains colloidal osmotic pressure.
* They are responsible for maintenance of viscosity of blood.
* They acts as buffer to regulate PH.
* They act as protein reserve.
* Gama globulin provide immunity.
* They are responsible for blood clotting.
* These proteins help in transport of hormones, drugs and metabolites.

Erythrocytes:

* erythrocytes or red blood cells are abundantly present in blood. These cells don’t have nucleus, mitochondria or ribosomes.
* the coloring pigment present in blood is hemoglobin in jelly form. These are biconcave in shape as it helps in easily pass through the narrow capillaries. They are flexible in nature.
* mean red cell diameter is 7.2 micron.
* thickness is 2.2 at the periphery and 1 micron at the center.
* normal life span of RBC is 120 days.

Normal count:
Males- 5 to 5.5 million cells/ cu mm
Females-4.5 to 5 million cells/cu mm.
Infants- 6-7 million cells/ cu mm.

Functions of RBC:-

* The hemoglobin present in blood helps in
* transport of oxygen
* transport of carbon dioxide.
* regulation of acid base balance.

Erythropoiesis: Is the process of formation of red blood cell. Erythropoiesis starts in the third week of intrauterine life in the mesoderm of yolk sac.
From the third month of intrauterine life it is in the liver and spleen. After 5th month of intrauterine life fetal bone marrow starts producing red cells.

Bone marrow is of two types.
1]  Red bone marrow
2]  Yellow bone marrow.

Red bone marrow produces RBC. During birth it is present in all the bones. In case of adults it is present in the flat bones like cranial bones, vertebrae, pelvic bones, ribs, sternum, upper end of long bones like femur and humorous.

The yellow bone marrow is mainly made up of adipose tissue.

Fate of RBC:-

The old and fragile RBC are phagocytized by reticuloendothelial system. In the reticuloendothelial cells they are broken down and HB is released. Subsequently HB is broken-down into haem and globulin. The Iron liberated is used again for synthesis of new HB. The remaining portion of haem called biliverdin. It is reduced to bilirubin in the liver and secreted through bile.

Polycythemia:

This is a condition where RBC count is increased above 8 million cells/cu mm.

Haemoglobin:

Hemoglobin is a conjugated protein present in the RBC. It forms 95% of the dry weight of RBC. Hemoglobin is a globular molecule made up of subunits. It is  involved in transport of carbon dioxide. It acts as a buffer.

ESR:

It is the rate at which red blood cells settle down. It is the measure of supernatant plasma separated out at the end of one hour when a column of blood is kept disturbed. The normal value in males – 0 to 5 mm at the end of an hour. In females – o -8 mm / hr.

ESR is increased in pregnancy and menstruation. it is increased in infections like tuberculosis rheumatoid arthritis, malignancy and anemic.

Mental Retardation :-

Mental retardation refers to significantly sub average general intellectual functioning, resulting in or associated with concurrent impairments in adaptive behavior and manifested during the developmental period. General intellectual functioning is assessed through intelligence tests developed for purpose and adopted to the conditions of the region. Sub average mental capacity refers to the intelligence quotient of 70 or below. Adoptive behavior refers to ability of personnel independence, and social responsibilities expected to ones age group and cultural group.

The change in adoptive behavior is as follows:-

1. During infancy and childhood:
* poor motor and sensory skill development.
* altered self help skills.
* defective socialization.

2. During childhood and adolescence:
* Poor academic skills.
* low reasoning and judgment capacity.
* less social skills.

Causes of Mental Retardation:-

a) Genetic factors:

* chromosomal abnormalities such as
- Turner’s syndrome.
- Down’s syndrome.
- Trisomy x syndrome.

b) Prenatal factors:
* maternal infections like rubella, syphilis, cytomegalovirus infection, and toxoplasmosis.
* Physical damage to the mother.
* Drug intoxication.
* endocrine disorders such as diabetes mellitus, hyperthyroidism etc.
* exposure to harmful radiations.

c) Intranatal causes:
* Instrumental delivery.
* Damage to the baby during delivery.
* Birth asphyxia.
* Premature birth.
* Instrumental delivery, kernicterus, prolonged birth, cyanosis of the baby, etc.

d) Post-natal causes:
- Central nervous system infection to baby such as encephalitis, measles, meningitis, septicemia etc.

e) Social and economical causes:
- Poverty, child born with low birth weight, child abuse, etc.

Benefits of laugh:-

Do you know the importance of laugh? If we laugh we will be happy. It keeps us charming. here are some beneifts of laugh and ways to be happy.

* As soon as you wake up from the bed see the mirror and smile at you.

* try to meet the people with smile.

* Our greet or wishes should make others happy.

* The body immune system is fully activated when you laugh.

* If you are suffering from a disease or sickness, try to be happy, and you will get 50% relief from your laugh itself.

* If we make others happy, we will be happy.

* We won’t get happiness by hurting others, for ever.

* Laugh makes you to do work actively.

* We can attract the people by smiling.

* smile is the first step to success.

* don’t laugh by teasing others.

* Your smile should not be dramatic.

* don’t get tense for the small things itself.

* Every problem has its own resolution.

* don’t be afraid of critical situations. Because the situations are created by us only.

* try to love the people. Then you will be happy.

* We need to enjoy the small things also. We won’t get big moment always.

* play makes us to be happy for some time.

* spend the leisure with children to be happy.

* Smile is the indication of well health.

ALCOHOLISM.
The consumption of an alcohol has become the fashion in this modern era. From ancient time itself man has enjoyed being intoxicated. It was used as an important part of social occasions and rituals. So the trend is still continuing. Now a day’s alcohol consumption is regarded as one of the most serious public health problem, in entire world.

Following are the some of effects of excess of alcohol consumption on our body:-

1. Effects on digestive system:
- It disturbs the absorption of nutrients from intestines. As it blocks the physiological absorption of Nutrients.

- Chance of developing peptic ulcer is high and various disorders of pancreas can be seen.

- Excess of alcohol consumption leads to loss of appetite, indigestion, vomiting, diarrhea and intestinal bleeding.

2. Effect on liver.
- Regular consumption reduces the normal functioning of liver.  The main disorder is alcoholic hepatitis, and cirrhosis of liver is common.  The shrinking and fibrosis of liver are common symptoms of cirrhosis of liver.

3. Effects on muscles.
- Muscular pain and weakness are manifested as the result of degeneration of contractile fibrils of the muscles.

4. Effect on circulatory system.

- The risk of coronary artery diseases, are very high in case of heavy drinkers.
- Increased blood pressure.

5. Effect on nervous system.

- The simple molecular structure of alcohol crosses the blood brain barrier, the physiological barrier which protects the brain from chemicals and drugs.
- Induces sleep
- Reduces the memory power.
- Prolonged excess intake affects the brain stem and spinal cord leading to lethargy, lack of concentration, attention.  Ultimately it leads to coma and death.

6. Effects on reproductive system.
- In males, sperm production is reduced by testes.
- In females, if alcohol is consumed during pregnancy, babies may die in the womb itself, or may born with deformity.

CHANGE IN SOCIO ECONOMIC ROLE:
- The person who addicts to alcohol loses much money. It leads to financial problems, and home management may get altered.
- The care of spouse may be neglected.
- The love towards children is altered.

How to maintain slim body:-

In this modern era everybody likes to be slim. Especially the women, but unfortunately they become obese because of sedentary life style, excess consumption of junk food , lack of exercises, mechanical life etc. The obesity has disturbed millions of people entire the world. It is not only making us ugly, but also leading to lot of diseases. Now a day’s obese children are also appearing.

Weight loss and healthy diet:-

1. Plan your diet: – we need to plan our diet as how many times we need to take, food. The eating habit should be practiced at regular interval .the light diet is preferred during, morning.

2. Don’t consume excess carbohydrate and fat diet, such as rice, ghee, butter, cheese, pannier, etc:-the excess carbohydrate stores in the form of fat and leads to obesity.

3. Avoid excess ice-cream eating.

4. Do the regular exercises, such as body free exercises.

5. Jag a mile every day, to keep the health in good condition.

6. Instead of using lift, use staircase:- it becomes an exercise and reduces fat.

7. Shouldn’t go for bed soon after dinner. Walk 200-300 steps after dinner. Give an hour gap between meals and sleep.

8. Avoid much snacks, curries, spicy foods, etc.

9. Eat vegetables and fruits to keep your body as you like.

10. Avoid excess pizza Berger.

11. Excess intake of non vegetarian such as chicken, mutton, pork to be avoided. You need not to stop completely.

12. Alcohol consumption should be in limit. Only a small amount is suggested.

13. if you are not doing any work whole day you need to do compulsory one hour exercise. The exercises such as sit and stand, jumping, skipping, etc.