Abnormal uterine bleeding (AUB) is bleeding from the uterus that is longer than usual or that occurs at an irregular time. Bleeding may be heavier or lighter than usual and occur often or randomly. AUB can occur: As spotting or bleeding between your periods.
Menorrhagia: Prolonged (>7 days) and/or heavy (>80 ml) uterine bleeding occurring at regular intervals.
Polymenorrhea: An abnormally short interval (<21>35 days) between menses.
Metrorrhagia: variable amounts of inter-menstrual bleeding occurring at irregular but frequent intervals.
The term metrorrhagia is often used for irregular menstruation that occurs between the expected menstrual periods. Oligomenorrhea is the medical term for infrequent, often light menstrual periods (intervals exceeding 35 days). Amenorrhea is the absence of a menstrual period in a woman of reproductive age.
Abnormal uterine bleeding can occur when a woman experiences a change in menstrual loss, or the degree of loss or vaginal bleeding pattern differs from that experienced by the age-matched general female population
AUB is not restricted to menstrual bleeding that is abnormally heavy, but includes bleeding that is abnormal in TIMING
Dysfunctional uterine Bleeding is type of Abnormal bleeding from the genital ...sonal patel
Dysfunctional uterine Bleeding is type of Abnormal bleeding from the genital tract- Factore, Types, Diagnosis, Treatment in that one type DUB- Define, sign and Symptoms, Diagnosis, Treatment, Management, hormonal Therapy in PPT made By sonal Patel
Pregnancy-induced-hypertension is hypertension that occurs after 20 weeks of gestation in women with previously normal blood pressure. Pregnancy-induced hypertension (PIH) complicates 6-10% of pregnancies. It is defined as systolic blood pressure (SBP) >140 mmHg and diastolic blood pressure (DBP) >90 mmHg. It is classified as mild (SBP 140-149 and DBP 90-99 mmHg), moderate (SBP 150-159 and DBP 100-109 mmHg) and severe (SBP ≥ 160 and DBP ≥ 110 mmHg).
Clean air, stable climate, adequate water, sanitation and hygiene, safe use of chemicals, protection from radiation, healthy and safe workplaces, sound agricultural practices, health-supportive cities and built environments, and a preserved nature are all prerequisites for good health.
Menorrhagia: Prolonged (>7 days) and/or heavy (>80 ml) uterine bleeding occurring at regular intervals.
Polymenorrhea: An abnormally short interval (<21>35 days) between menses.
Metrorrhagia: variable amounts of inter-menstrual bleeding occurring at irregular but frequent intervals.
The term metrorrhagia is often used for irregular menstruation that occurs between the expected menstrual periods. Oligomenorrhea is the medical term for infrequent, often light menstrual periods (intervals exceeding 35 days). Amenorrhea is the absence of a menstrual period in a woman of reproductive age.
Abnormal uterine bleeding can occur when a woman experiences a change in menstrual loss, or the degree of loss or vaginal bleeding pattern differs from that experienced by the age-matched general female population
AUB is not restricted to menstrual bleeding that is abnormally heavy, but includes bleeding that is abnormal in TIMING
Dysfunctional uterine Bleeding is type of Abnormal bleeding from the genital ...sonal patel
Dysfunctional uterine Bleeding is type of Abnormal bleeding from the genital tract- Factore, Types, Diagnosis, Treatment in that one type DUB- Define, sign and Symptoms, Diagnosis, Treatment, Management, hormonal Therapy in PPT made By sonal Patel
Pregnancy-induced-hypertension is hypertension that occurs after 20 weeks of gestation in women with previously normal blood pressure. Pregnancy-induced hypertension (PIH) complicates 6-10% of pregnancies. It is defined as systolic blood pressure (SBP) >140 mmHg and diastolic blood pressure (DBP) >90 mmHg. It is classified as mild (SBP 140-149 and DBP 90-99 mmHg), moderate (SBP 150-159 and DBP 100-109 mmHg) and severe (SBP ≥ 160 and DBP ≥ 110 mmHg).
Clean air, stable climate, adequate water, sanitation and hygiene, safe use of chemicals, protection from radiation, healthy and safe workplaces, sound agricultural practices, health-supportive cities and built environments, and a preserved nature are all prerequisites for good health.
Technologies are emerging and affecting our lives in ways that indicate we are at the beginning
of a Fourth Industrial Revolution, a new era that builds and extends the impact of digitization in
new and unanticipated ways.
Antepartum hemorrhage (APH) is defined as bleeding from or into the genital tract, occurring from 24+0 weeks of pregnancy and before the birth of the baby. The most important causes of APH are placenta praevia and placental abruption
Arab Republic of Egypt, is a transcontinental country spanning the northeast corner of Africa and southwest corner of Asia via a land bridge formed by the Sinai Peninsula.
Flipped classroom model is a part of a broad educational movement which covers the blended learning, inquirybased learning and other educational approaches and the tools that integrate flexible, efficient learners
Menopause is a biological stage in a woman's life that occurs when she stops menstruating and reaches the end of her natural reproductive life. This is not usually abrupt, but a gradual process during which women experience perimenopause before reaching post-menopause”
Evidence based practice is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients/clients.
Integration of the best research evidence with clinical expertise and patient values and using the best available research findings “to make clinical decisions that are most effective and beneficial for patients.
- It is a movement away from always doing things in the way in which we were taught and from decisions based on personal opinion. It requires that we look for and appraise research evidence to inform decisions about tests, treatments, patterns of practice, and policy.
Ask Converting information needs into clear questions
Acquire Seeking evidence to answer those questions
Appraise Evaluate the evidence for its validity and usefulness.
Apply Integrating findings with clinical expertise, patient needs, applying the finding.
Assess Evaluating performance.
Anti ulcer drugs and their Advance pharmacology ||
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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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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
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.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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.
3. Causes:
▪ Abnormal uterine bleeding is a symptom and not a
disease. Its causes include the following:
▪Early pregnancy complications (abortion, ectopic
pregnancy, hydatidiform mole).
▪Pelvic inflammatory disease (PID).
▪Benign tumors (uterine fibroids,cervical polyps
endometriosis, adenomyosis)
▪malignant tumors ( endometrial and cervical
carcinoma)
▪Dysfunctional uterine bleeding.
4. Clinicaltypes:
1. Menorrhagia (regular & cyclical):
- cyclical bleeding at normal intervals which is excessive in
amount or duration.
- causes: general: hypertension, anticoagulant therapy,
liver cirrhosis benign organic disease of genital
tract(fibroids, adenomyosios, PID) and may be
dysfunctional (ovulatory).
Treatment:1- treatment the causes and general measures
2-Non-hormonal:Anti-fibrinolytic, Anti-prostaglandins,
Hemostatic agents e.g. Dicynone
3-Hysterectomy:age>40y, failure of medical treatment
5. Clinical types:
2. Polymenorrhoea (regular & cyclical):
- Cyclical bleeding which is normal in amount but occurring at too-
frequent intervals of less than 21 days.
- cause: ovarian endometriosis, PID, DUB.
--- Commonly associated with menorrhagia
6. Clinicaltypes:
3. Polymenorrhagia:
- Cyclical bleeding which is both excessive and too frequent.
- Caused by: DUB, PID.
4. Metrorrhagia (irregular or acyclical):
- bleeding of any amount which acyclical occurring
irregularly or continuously not related to menstruation.
- causes(organic) : ulceration or infection of benign tumors,
malignancies (perimenopausal) complications of early
pregnancy, irregular use of contraceptive pills, anovular
DUB.
5. Menometrorrhagia: prolonged and irregular bleeding
7. Clinicaltypes:
5. Intermenstrual bleeding:
- often dysfunctional (fall in oestrogen secretion
following ovulation); 60% of ovulatory women have
erythrocytes in their cervical mucus if examined.
- common with cervical and endometrial polyps,
fibroids and cervical carcinoma
8. DysfunctionalUterineBleeding(DUB)
It is an abnormal bleeding from the uterus in the absence of
organic disease of the genital tract.
It is characterized by dysfunction of the uterus, ovary,
pituitary, hypothalamus or other part of reproductive system.
the pattern of bleeding is mainly heavy & regular
(menorrhagia) but it could be irregular uterine bleeding or
intermenstrual bleeding.
9. ClassificationofDUB:
Primary DUB:
Abnormal bleeding from the uterus where there is no
disease of the genital tract, no other disease responsible for
the bleeding, no IUCD and no history of sex hormone
administration.
Secondary DUB:
Abnormal bleeding from the uterus secondary to:
1. IUCD
2. Administration of sex hormones.
3. organic disease outside the genital tract e.g.
hypothyroidism, bleeding disorders.
10. PathophysiologyofprimaryDUB:
Depends on the pattern of bleeding and the age of the
patient.
Ovulatory DUB (heavy regular bleeding & painful):
1-Dsfunction polymenorrhea: short cycles due to- short follicular phase,
short luteal phase
-present in young women after menarche and it may occur
before menopause and after delivery.
-Treatment:
-Oral progesterone from day 15 for 10 days to prolong the
cycle.
11. 2-Dysfunction menorrhagia
Heavy or prolonged menstrual losses at normal intervals can be the
result of corpus luteum defects which present in the following ways:
1- Irregular ripening of the endometrium:
due to poor formation and function of corpus luteum
2- Irregular shading of the endometrium: due to incomplete and slow
degeneration of the corpus luteum (Halbans disease)
12. PathophysiologyofprimaryDUB:
Anovulatory DUB (heavy irregular bleeding):
- Occurs after menarche and before menopause.
- There is persistent proliferative endometrium in the
second half of the cycle.
1- Metropathia hemorrhagia (Schroeder's disease)
Short period of amenorrhea followed by excessive, prolonged,
painless bleeding.
the cause of bleeding :(estrogen withdrawal bleeding) decrease
estrogen level, exhaustion of the graffian follicale.
13. Diagnosis:
signs:A soft symmetrically enlarged uterus, an enlarged cystic ovary
Investigation: ultrasonography, hysteroscopy, endometrial biopsy
Treatment:
General measures
Medical management: non-hormonal and hormonal
Surgical :D&C, endometrial ablation, hysterectomy, radiotherapy-
when hysterectomy is contraindicated
14. 2- Threshold bleeding: acyclic bleeding
The ovary produces small amount of estrogen that fluctuated
above and below the threshold level required to support the
endometrium.
Endometrium biopsy shows thin endometrium and poorly
developed proliferative phase.
15. DiagnosisofDUB:
The diagnosis is by exclusion.
History: Age of the patient, menstrual history, pattern and
amount of menstrual loss.
Examination: abdominal and pelvic examination
Ultrasound (TAS & TVS).
Hystrescopy.
Endometrial biopsy (to exclude hyperplasia & carcinoma).
Hormonal assays: progesterone, LH, FSH and thyroid
function test.
Blood tests: CBC, clotting screen
16. ManagementofDUB:
Medical management:
1. Non-hormonal therapy:
- Non-steroidal anti-inflammatory drugs (NSAID); e.g.
mefenamic acid (ovulatory DUB).
- Antifibrinolytic drugs; e.g. tranexamic acid (to inhibit the
increased plasminogen activators & plasmin).
2. Combined oral contraceptive pills.
- low-dose oestrogen-progestogen is used (regulate the
cycle and reduce the amount of blood loss).
- progestogen dominant pills is used in progesterone
deficiency and oestrogen dominant pills are used in
oestrogen deficiency.
17. MedicalmanagementofDUB:
3. Progestogens:
- used in anovulatory cycles to reduce the blood loss.
- Norethisterone (primulot N) 5 mg tid and medroxy-progesterone acetate
10 mg tid.
4. Levonorgestrel-releasing IUCD:
- Induces endometrial atrophy with reduction of blood loss.
5. Androgens and gonadotrophin releasing hormone (GnRH)
- used when the above medical therapy has failed or surgery is
contraindicated.
- Androgens: danazol & gestrinone→ amenorrhoea by negative feedback
and direct action on endometrium and
- Gonadotrophin releasing hormone (GnRH)→ hypogonadal state
18. SurgicalmanagementofDUB:
Endometrial ablation (resection):
carried out under direct hysteroscopic vision using fluid for
distension and irrigation. The techniques include:
1. Laser ablation.
2. Endometrial loop resection using electrodiathermy.
3. Rollerbal electrodiathermy ablation.
4. Thermal balloon ablation.
Hysterectomy:
19. Nursing Diagnosis Goal Intervention Evaluation
Risk for fluid volume
deficit r/t active fluid
loss (abnormal
bleeding)
Patient will
experiences adequate
fluid volume and
electrolyte balance as
evidenced by urine
output greater than
30 ml/hr, heart rate
(HR) is 100 beats/min,
consistency of weight,
and normal skin
turgor.
Monitor and
document vital signs.
Monitor serum
electrolytes and urine
osmolality and report
abnormal values.
Administer parenteral
fluids as ordered.
Encourage patient to
drink prescribed fluid
amounts.
Monitor active fluid
loss from bleeding,
maintain accurate
input and output.
After nurses done the
interventions, patient
shows some
progresses which are
urine output greater
than 30 ml/hr, heart
rate (HR) is 100
beats/min,
consistency of weight,
and normal skin
turgor.
20. Nursing Diagnosis Goal Intervention Evaluation
Impaired gas
exchange r/t altered
oxygen supply
secondary to blood
loss
Patient will maintains
optimal gas exchange
as evidenced by
normal arterial blood
gases (ABGs)
•Monitor respiration’s
rate, depth and rhythm
•Monitor vital signs
•Assess for signs and
symptoms of
hypoxemia:
tachycardia,
restlessness,
diaphoresis, headache,
lethargy, and confusion
•Assess for changes in
orientation and
behavior
•Assess skin color for
development of
cyanosis.
•Maintain oxygen
administration device
as ordered, attempting
to maintain oxygen
saturation at 90% or
greater.
•Facilitate patient to
high-Fowler’s position.
Patient will maintain
normal arterial blood
gases.
Normal adult arterial
pH= 7.35-7.45
pCO2 = 35-45 torr
pO2 = >79 torr
Normal adult venous
pH = 7.31-7.41
pCO2 = 41-51 torr
pO2 = 30-40 torr
21. Nursing Diagnosis Goal Intervention Evaluation
Acute pain r/t lower
abdominal cramps e/b
patient’s facial
expression
The lower abdominal
pain level will reduce
to optimum level.
•Monitor pain
characteristics
•Teach the use of non-
pharmacologic
techniques
•monitor signs and
symptoms associated
with pain
•positioning according
patient comfort
•Provide rest periods
to facilitate comfort,
sleep, and relaxation
After nursing actions
are taken, level of pain
complained by patient
had reduced to
optimum level and
patient feel comfort.
22. Nursing Diagnosis Goal Intervention Evaluation
Fear related to
excessive bleeding e/b
restlessness of patient
and patient’s
complain.
The patient will report
fear and anxiety are
reduced to a
manageable level.
Patient will be able to
rest without being
restless.
Identify patient’s
perception of threat
represented by the
situation
Encourage patient to
acknowledge and
express fears
Provide opportunity
for discussion of
personal feelings or
concerns and future
expectations.
Identify previous
coping strengths of the
patient and current
areas of control or
ability
Encourage use of
relaxation technique
like deep breathing,
guided imagery
After nursing
intervention is done,
the patient has report
fear and anxiety are
reduced to a
manageable level.
Patient is not restless.