An outline on how to approach the problem of pregnancy anaemia from a clinical standpoint. Specially presented for the benefit of students and primary care physicians.
An outline on how to approach the problem of pregnancy anaemia from a clinical standpoint. Specially presented for the benefit of students and primary care physicians.
Iron deficiency anemia (IDA) Diagnosis & ManagementDoctor AlTokhy
Iron Deficiency Anemia
Causes & Risk Factors
Findings & Clinical Features
History & Physical Exam
Diagnosis & Management
Screening & Prevention
family medicine presentation and summary
for medical students and residents
ANEMIA IN PREGNANCY BY DR SHABNAM NAZ.pptxShabnam Shaikh
pathological condition in which the oxygen carrying capacity of red blood cells is insufficient to meet the body ‘s needs
The world health organization uses haemoglobin Concentration to define anaemia, below 120 g/l in nonpregnant Women and 110 g/l in pregnancy.
Anaemia in pregnancy is defined as
first trimester haemoglobin (Hb) less than 110 g/l
second/third trimester Hb less than 105 g/l
postpartum Hb less than 100 g/l
PREVALANCE-
40% of world ‘s population
(35% non-preg 51%pregnant)
56% in Pakistan
MORTALITY
40-60% IN Pakistan
18% in industerlised countries
Reason of anemia during pregnancy
Physiological hamodilution
Increase iron demand
Diminished intake of iron--- bcs of nvp
Disturbed metabolism
Pre-pregnancy health status
Excess demand. (Twin)
During pregnancy, iron requirements increase (due to expanding red cell mass and increasing fetal requirements)by 2.5 mg/day in the first trimester to 6.6 mg/day in the third trimester.
There is an increase in iron absorption from the gastrointestinal tract during pregnancy.
Folic acid requirements also increase in pregnancy due to increased red cell mass and the expanding feto–placental unit.
Vitamin B12 decreases in pregnancy (205–1025 pg/ml to 30–510 pg/ml in pregnancy). Despite lower concentrations, there is rarely, if ever, evidence of biochemical vitamin B12 deficiency.
gastrointestinal issues affecting absorption
short inter-pregnancy interval
Other :
parasitic diseases
micronutrient deficiencies
genetically inherited hemoglobinopathies
TYPES OF ANAEMIA DURING PREGNANCY
Physiologic
Pathologic:
1 . Hereditary causes
Thalassaemias , Sickle Cell. Haemoglobinopathies , Haemolytic anaemias , other type ofHaemgobinopathies.
2 .Acquired Causes
A . Nutritional---Iron deficiency anaemia
( microcytic hypocromic anaaemia , Folate deficiency anaemia ( megaloblastic anaemia ) , Vit B12 Deficiency anaemia ( Megaloblastic anaemia )
B . Anaemia due to bone marrow failure ( aplstic / hypo plastic
anaemia ).
C . Anaemia secondary to inflammation , chronic disease ,
malignancy.
D . Anemia due to acute / chronic blood loss.
E . Acquire hemolytic anemia.
IRON ABSORBTION
Dietary iron (heme and non heme)
- heme-animal blood flesh viseras
-Non heme-cerels, seeds, vegetables, milk eggs.
Factors increases iron absorbtion
Heme iron
Proteins
Meat
Ascorbic acid
Fermentation Ferrous iron
Gastric acidity
Alcohol
Low iron stores
Increase erethropiioetic activity(hight altitue,bleeding)
FACTROS DECREASES IRON ABSORBTION
Phytates
Calcium
Tennins, tea, coffee, herbal drinks
Fortified iron supplements
IRON LOSS
PHYSIOLOGIC FACTORS
Desquamation of cells( intestine, skin)
Menstruation
Delivery
Lactation
PATHOLOGIC FACTORS
Hookworms /other helmentis
Bleeding from GIT
Allergies
Occult blood loss, excess menses,APH
Pharmaco-kinetics of Iron
Normal diet contain about 14 mg of iron
Absorption of iron is 5-10%
Additional daily iron demand in early pregnancy 2-3 mg/day
In late pregnancy 6-7 mg/day
So daily su
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Iron deficiency anemia (IDA) Diagnosis & ManagementDoctor AlTokhy
Iron Deficiency Anemia
Causes & Risk Factors
Findings & Clinical Features
History & Physical Exam
Diagnosis & Management
Screening & Prevention
family medicine presentation and summary
for medical students and residents
ANEMIA IN PREGNANCY BY DR SHABNAM NAZ.pptxShabnam Shaikh
pathological condition in which the oxygen carrying capacity of red blood cells is insufficient to meet the body ‘s needs
The world health organization uses haemoglobin Concentration to define anaemia, below 120 g/l in nonpregnant Women and 110 g/l in pregnancy.
Anaemia in pregnancy is defined as
first trimester haemoglobin (Hb) less than 110 g/l
second/third trimester Hb less than 105 g/l
postpartum Hb less than 100 g/l
PREVALANCE-
40% of world ‘s population
(35% non-preg 51%pregnant)
56% in Pakistan
MORTALITY
40-60% IN Pakistan
18% in industerlised countries
Reason of anemia during pregnancy
Physiological hamodilution
Increase iron demand
Diminished intake of iron--- bcs of nvp
Disturbed metabolism
Pre-pregnancy health status
Excess demand. (Twin)
During pregnancy, iron requirements increase (due to expanding red cell mass and increasing fetal requirements)by 2.5 mg/day in the first trimester to 6.6 mg/day in the third trimester.
There is an increase in iron absorption from the gastrointestinal tract during pregnancy.
Folic acid requirements also increase in pregnancy due to increased red cell mass and the expanding feto–placental unit.
Vitamin B12 decreases in pregnancy (205–1025 pg/ml to 30–510 pg/ml in pregnancy). Despite lower concentrations, there is rarely, if ever, evidence of biochemical vitamin B12 deficiency.
gastrointestinal issues affecting absorption
short inter-pregnancy interval
Other :
parasitic diseases
micronutrient deficiencies
genetically inherited hemoglobinopathies
TYPES OF ANAEMIA DURING PREGNANCY
Physiologic
Pathologic:
1 . Hereditary causes
Thalassaemias , Sickle Cell. Haemoglobinopathies , Haemolytic anaemias , other type ofHaemgobinopathies.
2 .Acquired Causes
A . Nutritional---Iron deficiency anaemia
( microcytic hypocromic anaaemia , Folate deficiency anaemia ( megaloblastic anaemia ) , Vit B12 Deficiency anaemia ( Megaloblastic anaemia )
B . Anaemia due to bone marrow failure ( aplstic / hypo plastic
anaemia ).
C . Anaemia secondary to inflammation , chronic disease ,
malignancy.
D . Anemia due to acute / chronic blood loss.
E . Acquire hemolytic anemia.
IRON ABSORBTION
Dietary iron (heme and non heme)
- heme-animal blood flesh viseras
-Non heme-cerels, seeds, vegetables, milk eggs.
Factors increases iron absorbtion
Heme iron
Proteins
Meat
Ascorbic acid
Fermentation Ferrous iron
Gastric acidity
Alcohol
Low iron stores
Increase erethropiioetic activity(hight altitue,bleeding)
FACTROS DECREASES IRON ABSORBTION
Phytates
Calcium
Tennins, tea, coffee, herbal drinks
Fortified iron supplements
IRON LOSS
PHYSIOLOGIC FACTORS
Desquamation of cells( intestine, skin)
Menstruation
Delivery
Lactation
PATHOLOGIC FACTORS
Hookworms /other helmentis
Bleeding from GIT
Allergies
Occult blood loss, excess menses,APH
Pharmaco-kinetics of Iron
Normal diet contain about 14 mg of iron
Absorption of iron is 5-10%
Additional daily iron demand in early pregnancy 2-3 mg/day
In late pregnancy 6-7 mg/day
So daily su
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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6. Treatment
• Hb <10g/dl but >2g/dl, 2 tabs, <8g/dl 3 tabs
• Oral treatment=Ferrous sulphate and Folic acid
• <6g/dl=transfuse
• After 36 weeks=Transfuse when HB is <8g/dl (no time for build up)
Megaloblastic anemia
Causes
• Folic acid deficiency
• Vitamin B12 deficiency (give vitamin B12 100micro grams)
Risk factors
• Menorrhagia
• Small interval of pregnancy
• Poor absorption
Symptomatic
• Weakness
• Tachycardia
• Fatigue
• Pallor
7. Treatment of anemia
Iron supplements (tablets, injection or syrup)
• Ferrous sulphate (Not in the 1st
3 months)
• Folic acid
Roles of folic acid
• Development of RBC (7-10 days for development)
• Prevent thrombosis
• Prevent neural tube defects
Two forms
• Fefol (Ferrous sulfate and folic acid)
• Hematinic (Fefol plus vitamin C(enhance absorption of folic acid))
