headache postcoital

A patient in their 50s presented with postcoital severe headache. Computed tomography revealed a subarachnoid haemorrhage but also a subdural hematoma at the left convexity. CT angiography revealed a large irregular anterior communicating artery aneurysm but also cortical serpiginous vessels suggestive of a vascular malformation adjacent to the subdural hematoma in the left convexity. DSA confirmed the ruptured aneurysm but also revealed a Borden 3 type dural arteriovenous fistula on the left convexity. The fistula had arterial supply mostly from middle meningeal artery branches and venous drainage directly to a left cortical vein adjacent to superior sagittal sinus...

INTRODUCTION: An 'on-demand' contraceptive pill may suit women having infrequent sex. We assessed the feasibility of e-commerce pharmacy provision and acceptability of levonorgestrel (LNG) 1.5 mg for pericoital use in Kenya. METHODS: A 12-month prospective, single-arm, open-label, interventional study conducted from August 2020 to August 2021. A total of 897 women aged 18-49 years at risk of pregnancy and having infrequent sex (ie, six times or fewer coital frequency/month) were screened and enrolled...

Sexuality is an essential aspect of quality of life. Nevertheless, sexual intercourse is physically challenging and leads to distinct changes in blood pressure, heart, and respiratory rate that may lead to vital complications. We present a case report of a 22-year-old female suffering from subarachnoid hemorrhage after sexual intercourse. The patient was immediately transported to hospital by emergency medical services and, after diagnosis, transferred to a tertiary hospital with neurosurgical expertise but died within 24 hours...

OBJECTIVES: The objective was to identify adolescent preferences for emergency department (ED)-based education about emergency contraception. METHODS: This was a cross-sectional computerized survey, using adaptive conjoint analysis (ACA). Patients were eligible if they were females ages 14 through 19 years old and were seeking care in one of two urban EDs. Patients were excluded if they were too ill to participate in the survey or if they were non-English speaking...

Ploycythaemia vera (PV) is most common of chronic myeloproliferative disorder that involves the multipotent haemaotopoietic progenitor cells. PV has indolent course and recognised either by incidental discovery of high haemoglobin or haemtocrit. PV may present with aquagenic pruritus (AP) for years together without any other sign and symptoms. So advice of simple complete bood count as a routine in every case of pruritus can be helpful to diagnose it timely thereby dreaded complications of PV, related to hyperviscosity of blood like thrombosis both arterial and venous can be managed antecedently...

BACKGROUND: Emergency contraception (EC) is used to prevent unintended pregnancies. The current gold standard for oral EC is levonorgestrel (LNG) administered as a single 1.5-mg dose or in 2 doses of 0.75 mg separated by 12 hours. LNG has shown to be effective up to 72 hours after coitus. Ulipristal acetate (UPA) is a selective progesterone receptor modulator approved for EC use in the United States in August 2010. UPA is administered as a one-time, 30-mg dose within 120 hours of intercourse...

OBJECTIVE: To review the pharmacology, pharmacokinetics, efficacy, and safety of data of ulipristal acetate, a new emergency contraceptive approved for use up to 120 hours after unprotected intercourse. DATA SOURCES: Articles pertaining to the topic were identified and reviewed through searches of PubMed (1994-March 2011) and clinicaltrials.gov, using the key terms ulipristal and CDB-2914. Ella approval documents were obtained and reviewed from Drugs@FDA on the Food and Drug Administration (FDA) Web site...

BACKGROUND AND IMPORTANCE: We describe an unusual presentation of a ruptured aneurysm of the posterior communicating artery with an acute intracranial hematoma between the dural layers associated with an acute spinal epidural hematoma descending to L1. CLINICAL PRESENTATION: A 35-year-old woman presented 3 hours after ictus with a postcoital headache, neck stiffness, and bilateral abducens cranial nerve palsy. No other neurological deficits were present. Clinically, she had a subarachnoid hemorrhage World Federation of Neurosurgical Societies grade 1...

BACKGROUND: Emergency contraception can prevent unintended pregnancies, but current methods are only effective if used as soon as possible after sexual intercourse and before ovulation. We compared the efficacy and safety of ulipristal acetate with levonorgestrel for emergency contraception. METHODS: Women with regular menstrual cycles who presented to a participating family planning clinic requesting emergency contraception within 5 days of unprotected sexual intercourse were eligible for enrolment in this randomised, multicentre, non-inferiority trial...

OBJECTIVE: To evaluate the efficacy and safety of ulipristal acetate as emergency contraception in women presenting 48-120 hours after receiving ulipristal acetate for unprotected intercourse. METHODS: Women aged 18 years or older with regular cycles who presented for emergency contraception 48 to 120 hours after unprotected intercourse were enrolled in 45 Planned Parenthood clinics and treated with a single dose of 30 mg ulipristal acetate. Pregnancy status was determined by high-sensitivity urinary human chorionic gonadotropin testing and return of menses...

OBJECTIVE: To explore the attitudes of urban, minority adolescent girls about an emergency department (ED)-based intervention to address emergency contraceptive pill (ECP) use. METHODS: We conducted an in-depth, semistructured interview study of healthy, 15- to 19-year-old African-American girls seeking care in a children's hospital ED. Purposive sampling was used to recruit sexually and nonsexually active adolescents and those with or without a history of pregnancy...

A rare case of primary headache associated with sexual activity in a 40-year-old married Indian man who had coital and postcoital headaches responsive to indomethacin is reported.

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Emergency contraception may avoid pregnancy after unprotected intercourse or when regular contraceptive measures fail. Levonorgestrel, a synthetic gestagen, is recommended for emergency contraception as a single 1.5-mg dose or, alternatively, two 0.75-mg doses taken 12 h apart. Its efficacy is moderate, preventing about 80% of pregnancies. Efficacy is higher the earlier after unprotected intercourse the drug is taken, but it may be administered up to 5 days post-coitum. Tolerance is similar to, or better than, those of other oral emergency contraceptives...

OBJECTIVE: This study was aimed to evaluate a marketed mineralo-herbal preparation containing plants known to have potent contraceptive activity, or contraindicated for use during pregnancy in folklore/ancient Indian literature and recommended for use as an appetizer and headache, hyperacidity and chronic constipation reliever for effect on spermatogenesis and implantation-cum-early postimplantation events in adult Sprague-Dawley rats. METHODS: The preparation, suspended in distilled water with the addition of sterile gum acacia, was administered at 1 g/kg daily dose (extrapolated from human dose on surface area basis) to male rats covering one spermatogenic cycle and to female rats during the entire preimplantation and early postimplantation period by oral route...

OBJECTIVE: The aim of the study was to asses effectiveness and adverse reactions in adolescent girls received Postinor (0.75 mg Levonorgestrel) for emergency contraception. METHOD: Forty-two teenage girls with established regular menstrual cycles for 24 months period and 128 intercourses are included. Excluding criteria are: clinical data for gynecological endocrine diseases, other contraceptive methods used and contraindication for using gestagens. The girls received tablets Postinor containing 0...

INTRODUCTION: Recent studies have shown that a single dose of 1.5 mg levonorgestrel is an effective and safe emergency contraceptive but detailed information on its menstrual side effects is lacking. This study assessed the vaginal bleeding patterns in healthy women who used the medication for emergency contraception. STUDY DESIGN: A prospective observational study of 544 women who sought emergency contraception and volunteered to use a single dose of 1.5mg. levonorgestrel...

OBJECTIVE: To compare the efficacy, patient acceptability and adverse effects of low-dose mifepristone (10 mg) with the levonorgestrel regimen (2 doses of 750 microg given 12 hours apart) for emergency contraception. METHODS: This randomized controlled trial compared mifepristone (10 mg) to levonorgestrel (2 doses of 750 microg given 12 hours apart) in the context of emergency contraception within 120 hours of unprotected intercourse. The primary outcome measure was unintended pregnancy...

Emergency contraception was introduced in Nigeria over two decades ago, but few women have used this method even in emergency situations because of the side effects. To find an acceptable levonorgestrel regimen for emergency contraception in our community, the two-dose regimen 0.75-mg levonorgestrel 12 h apart (group A) and the single dose 1.5-mg levonorgestrel (group B) were studied in 1118 volunteers. Mild side effects such as nausea, vomiting, lower abdominal pains, menorrhagia, dizziness, headache, and breast tenderness were reported...

OBJECTIVES: To compare the quality of clinical care in walk-in centres with that provided in general practice and by NHS Direct. DESIGN: Observational study involving assessment of clinicians by standardised patients. SETTING: 20 walk-in centres, 20 general practices, and 11 NHS Direct sites. PARTICIPANTS: 297 consultations with standardised patients, 99 in each setting, carried out by professional role players trained to play five clinical scenarios (postcoital contraception, chest pain, sinusitis, headache, and asthma)...