A caesarean section is a surgical procedure to deliver a baby through incisions in the mother's abdomen and uterus. It is usually performed after 24 weeks of gestation if vaginal delivery would put the mother or baby's health at risk. The incidence of caesarean sections has steadily increased over the last decade due to improved safety and awareness of fetal well-being. The surgery involves making incisions through the skin, muscles and two layers of uterine tissue to deliver the baby and placenta. Proper pre and post-operative care is needed to prevent complications for both mother and baby.
LSCS is the most common obstetric procedure but it can be very difficult to manage in cases of previous LSCS, low lying placenta, and PPH. please check out the youtube links to the videos embedded in this PPT.
ADHESIOLYSIS DURING LSCS https://youtu.be/2Hv80v3yu20
BLADDER DISSECTION https://youtu.be/6qsaTJ1yRUY
RECTUS SHEATH ADHESIOLYSIS https://youtu.be/SryJHjuGsME
VECTIS IN FLOATING HEAD DURING LSCS https://youtu.be/3PECperU8Cw
BREECH DELIVERY https://youtu.be/i-LcmTNNVvU
TRANSVERSE LIE WITH IUFD https://youtu.be/hG28uqpkdpU
CONJOINT TWINS https://youtu.be/KLR7D6wkf38
LSCS IN PLACENTA PREVIA https://youtu.be/dNKQwt4KhVY
SYSTEMATIC PELVIC DEVASCULARISATION https://youtu.be/UwSH6V6GBVw
LSCS is the most common obstetric procedure but it can be very difficult to manage in cases of previous LSCS, low lying placenta, and PPH. please check out the youtube links to the videos embedded in this PPT.
ADHESIOLYSIS DURING LSCS https://youtu.be/2Hv80v3yu20
BLADDER DISSECTION https://youtu.be/6qsaTJ1yRUY
RECTUS SHEATH ADHESIOLYSIS https://youtu.be/SryJHjuGsME
VECTIS IN FLOATING HEAD DURING LSCS https://youtu.be/3PECperU8Cw
BREECH DELIVERY https://youtu.be/i-LcmTNNVvU
TRANSVERSE LIE WITH IUFD https://youtu.be/hG28uqpkdpU
CONJOINT TWINS https://youtu.be/KLR7D6wkf38
LSCS IN PLACENTA PREVIA https://youtu.be/dNKQwt4KhVY
SYSTEMATIC PELVIC DEVASCULARISATION https://youtu.be/UwSH6V6GBVw
This topic contains definition, instruments, indications, contraindications, prerequisites, advantages, procedure, complications and hazards of ventouse or vaccum delivery.
Labour induction
Induction of labour
Guidelines on induction of labour
Guidelines on labour induction
induction of labour is not risk free
prostaglandins for induction of labour
Bishop score
Cervical ripening techniques
mechanical and pharmacological induction of labour
Post dates induction
options for cervical ripening
oral vs. vaginal misoprostol
advantages diadvantages and techniques for induction of labour
gynecology & obstetrics
Labour induction methods
review of guidelines for labour induction
Please find the power point on Anatomy of Femlae reproductive organs . I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Bladder injuries are rare. But when present in cases of polytrauma they pose both a diagnostic as well as surgical challenge to the attending surgeon. Understanding the mechanisms underlying bladder injuries is pivotal in developing a diagnostic algorithm in order to avoid missing of any urologic injury. Once the extent and site of damage is diagnosed then prompt surgical intervention is the mainstay of treatment. The pathophysiology and management of bladder injuries is discussed in this paper.
This topic contains definition, instruments, indications, contraindications, prerequisites, advantages, procedure, complications and hazards of ventouse or vaccum delivery.
Labour induction
Induction of labour
Guidelines on induction of labour
Guidelines on labour induction
induction of labour is not risk free
prostaglandins for induction of labour
Bishop score
Cervical ripening techniques
mechanical and pharmacological induction of labour
Post dates induction
options for cervical ripening
oral vs. vaginal misoprostol
advantages diadvantages and techniques for induction of labour
gynecology & obstetrics
Labour induction methods
review of guidelines for labour induction
Please find the power point on Anatomy of Femlae reproductive organs . I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Bladder injuries are rare. But when present in cases of polytrauma they pose both a diagnostic as well as surgical challenge to the attending surgeon. Understanding the mechanisms underlying bladder injuries is pivotal in developing a diagnostic algorithm in order to avoid missing of any urologic injury. Once the extent and site of damage is diagnosed then prompt surgical intervention is the mainstay of treatment. The pathophysiology and management of bladder injuries is discussed in this paper.
Emergencies that occur in pregnancy or during or after labor and delivery.
main emergencies are
Ectopic Pregnancy
Uterine Inversion
Obstetrical Shock
Cord Prolepses
Amniotic Fluid Embolism
Postpartum Hemorrhage
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
3. INTRODUCTION
An operative procedure that is carried
out under anesthesia whereby the
fetus, placenta and membranes are
delivered through an incision in
abdominal wall amd the uterus
Usually carried out after viability has
been reached i.e. 24-48 weeks of
gestation onwards.
4. The first operation performed on a
women is referred to as a primary
caesarean section.
When operation is performed in
subsequent pregnancies,it is called
repeat caesarean section.(C/S)
5. INCIDENCE:
The incidence of caesarean is steadly
raising.
During the last decade there has been
two-three folds rise in the inciddence
from the initial rate of about 10%.
Factors responsible are increased safety
of operation due to improved anesthesia,
availability of blood transfusion and
antibiotics.
Increased awareness of fetal well being
and idenification of risk factors have
caused reduction of difficult operation or
manipulative vaginal deliveries.
6. Indication for Caesarean section
1. Absolute:
Vaginal Atresia
Advanced carcinoma of cervix
Cervical or broad of contracted pelvis.
Severe degree of contracted pelvis.
2. Relatives:
Cephalopelvic disproporton
Previous uterine scar
Fetal distress.
Malpresentations
Antepartum hemorrhage
Elderly primigravidae
Chronic hypertension
Diabetes
Pelvis atresia
9. Time of operation:
A. Elective caesarean section:
The term elective indicates that the
decision to deliver the baby by
caesarean has beenmade during the
pregnancy anh before the onset of
labour.
It means pre-planning for doing
caesarean section.
Indication:
CPD
Placenta previa
Bad obstetric history
10. B. Emergency caesarean
delivery:
When the operation is performed due
to unforseen complication arising
either during pregnancy or labour
without wasting time following the
decision.
Indication:
Cord prolapse
Uterine rupture
Eclampsia
Prolonged first stage of labour
Abnormal uterine contraction
11. Types of operation:
1. Lower segment caesarean section:
Is lesser muscular than the upper
segment of the uterus.
Transverse incision is made in the lower
segment this heals faster and
sucessfully than an incision in the upper
segment of the uterus.
There is less muscle and more fibrous
tissue in lower segment which reduces
the risk of rupture in a subsequent
pregnancy.
Also known as “pfannensiel or bikini line
12. 2. Classical caesarean section:
In this baby is extracted through an
incision made in upper segment of
uterus.
Is rarely performed.
Operation is done only under forced
circumstances, such as:
carcinoma of cervix
Big fibroid on lower segment
constriction ring
lower segment is difficult or risky
example:placenta previa, adhesion due to
previous abdominal operation.
14. Operation procedure:
The non gravid uterus is a pelvic organ closely
covered by a layer of pelvic peritoneum.
As pregnancy advances, the uterus grows up into
the abdomen and this peritoneum rises up with the
uterus and comes into contact with the abdominal
peritoneum. Each of these layers must be incision
and repaired.
The abdominal peritoneum is situated below the
abdominal muscles layer.
The anatominal layers are:
a) Skin
b) Fat
c) Rectus sheath
d) Rectus abdominis
e) Abdominal peritoneum
f) pelvic peritoneum
g) Uterine muscles
15. The operation most commonly carried out
is the lower segment caesarean section.
The lower segment incision is in the less
muscular and active part of the uterus and
heals better.
The main reason for preferring the lower
uterine segment technique is the reduced
incidence of dehiscent pregnancy.
The abdomen is opened and the loose
folds of the peritoneum over the anterior
aspect of the lower uterine segment and
above the bladder is incised. The operator
continues so incise this further to visualize
the fundus of bladder which is then pushed
down and away from the surgeon.
16. The surgeon direct the fetal head out while
the assistant applies fundal pressure to hip
the delivery of the baby.
Oxytocins may be given by the anesthetist
after delivery of the baby and clamping the
cord.
When the baby and placental have been
delivered the uterus is sutured.
This is usualy done in two layers. The
peritoneum then be clased over uterine
wound to exclude it from the peritoneal
cavity.
The rectus sheath is closed then the layers
of fat and finally the skin is sutured with the
surgeons choice of materials; commonly
17. Nursing Management
A. Pre-operative management:
Patient should be physically prepared
i.e.abdomen,back ,private parts and upper
part os thigh are shaved and cleaned.
Prepare mother psychologically by
providing assurance a nd explanning the
indication,procedure and need of
caesarean section.
Administration of IV infusion of 50%
dextrose to avoid hypotension following
spinal anaesthesia,the infusion line is
maintained patent by an intra venous
cannula.
Blood grouped and cross matched for
emergency requirement.
18. Bladder should be empty by inserting
foleys catheter.This may be done
before and after induction of
anaesthesia.
Mother should be in NPO for about 8
hours.
Patient should be in clean
gown,valuable ornament should be
taken off and all make up should be
removed.
If elective caesarean section then
Ranitidine 150mg should be given
orally in the night before and repeated
one hour before surgery to prevent
19. B. Post operative care :
1. Immediate care (4-6 hours):
• In the immediate recovery period,the blood
pressure is recorded in every 2 hourly.
• The wound must be inspected half hourly
to detect any blood loss.
• The lochia are inspected and drainage
should be small initially,Following general
anaesthesia, the women is nursed in left
lateral or recovery position until she is fully
conscious.
• Analgesic is given as prescribed.
20. 2. First 24 hours:
IV fluids are continued,blood transfusion is helpful
in anemia mothers.
Parental antibiotic is usually given for 1st 48
hours,analgesics is the form of pethidine 75-100mg
are given as needed.
Ambulation is encouraged following day of surgery
and baby is given to mother.
3. After 24 hours:
TPR are usually checked every 4 hourly
Orally feeding is started with clear liquid and then
advanced to normal diet and IV fluid are continued
for about 48 hours.
Catheter may be removed on following day when
the women is able to get up to the toilet. She should
be helped to get out of bed.
The mother must be encouraged to take rest and
provide care to the baby and should breast feed the
21. Complication:
Mother:
partum hemorrhage related to uterine atony
and rarely blood coagulation disorders.
Shocks related to blood loss.
Anesthesia hazards
Sepsis, secondary PPH.
Thrombosis
Lung infection post.
22. Late compilcation:
Menstrual irregularity
Chronic pelvic pain
Backache
Fetus:
Iatrogenic prematurity.
Respiratory distress syndrome.
Injury to baby due to surgical knife.
Birth asphyxia due to anaesthesia.