Vaginal bleeding in early pregnancy can be caused by abortion, ectopic pregnancy, or hydatidiform mole. For a 27-year old woman presenting with vaginal bleeding 1 day after a missed period, the doctor would check a beta hCG test and ultrasound to determine if she is pregnant and if the pregnancy is intrauterine or ectopic. If the pregnancy is not viable or located outside the uterus, management may involve expectant care, misoprostol, or uterine aspiration depending on the specific diagnosis and ultrasound findings.
This presentation distinguishes miscarriage with its types and causation factors in an organised table method giving the learner a quick guide into this intriguing topic of great debate. -Enjoy and remember to check the sources at the end to further strengthen your medical background.
This presentation distinguishes miscarriage with its types and causation factors in an organised table method giving the learner a quick guide into this intriguing topic of great debate. -Enjoy and remember to check the sources at the end to further strengthen your medical background.
Meconium-stained amniotic fluid is common complication, seen in 1 out of every 5 pregnancies.Golden rule for management of MSAF is Foetal Heart Monitoring
In this introductory remark at workshop on vaginal hysterectomy where Dr Shirish Seth was operating faculty.
I spoke “lets promote and propagate vaginal hysterectomy which is an indigenous surgery in line with PM Modi’s mission of MAKE IN INDIA.
Vaginal hysterectomy is like Aam admi surgery which is in the best interest of patients and has best scientific evidences in its favour."
Let us not be driven by glamour,gadgets and gimmicks."
Meconium-stained amniotic fluid is common complication, seen in 1 out of every 5 pregnancies.Golden rule for management of MSAF is Foetal Heart Monitoring
In this introductory remark at workshop on vaginal hysterectomy where Dr Shirish Seth was operating faculty.
I spoke “lets promote and propagate vaginal hysterectomy which is an indigenous surgery in line with PM Modi’s mission of MAKE IN INDIA.
Vaginal hysterectomy is like Aam admi surgery which is in the best interest of patients and has best scientific evidences in its favour."
Let us not be driven by glamour,gadgets and gimmicks."
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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.
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
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
Evaluation of antidepressant activity of clitoris ternatea in animals
vaginal bleeding in early pregnancy
1. Approach to vaginalApproach to vaginal
bleeding duringbleeding during
pregnancypregnancy
Basma mohamed abdel
aziz
Assistant lecture of
Family medicine ,Suez Canal University
5. Dr.Basma ,FM,SCU,2012-2013
Types of abortion
Threatened abortion.
Inevitable abortion.
Incomplete abortion.
Complete abortion.
Missed abortion
Septic abortion: Any type of
abortion, which is complicated by
infection
Recurrent abortion: 3 or more
successive spontaneous abortions
8. Dr.Basma ,FM,SCU,2012-2013
Lab Studies:
Suspect gestational trophoblastic neoplasia when a positive
pregnancy test result occurs in the absence of a fetus.
A serum HCG greater than 100,000 mIU/mL should raise the
concern of gestational trophoblastic disease (GTD).
A CBC count may help detect anemia secondary to vaginal
bleeding.
Liver enzymes may become elevated in the presence of
metastasis to the liver.
Assessment:-
10. Dr.Basma ,FM,SCU,2012-2013
Ectopic pregnancyEctopic pregnancy
The classic clinical triad of ectopic pregnancy is pain,
amenorrhea, and vaginal bleeding; only about 50% of patients
present with all 3 symptoms.
clinicians should have a high index of suspicion for ectopic
pregnancy in any woman who presents with these symptoms
and who presents with physical findings of pelvic tenderness,
enlarged uterus, adnexal mass, or tenderness.
Approximately 20% of patients with ectopic pregnancies are
hemodynamically compromised at initial presentation, which
is highly suggestive of rupture.
11. Dr.Basma ,FM,SCU,2012-2013
Case one
27 years old , married from 6 month ,her
menses is regular , presented with vaginal
bleeding from one day , she had a history of
amenorrhea one week after the missed period
What is your approach to mange such case?What is your approach to mange such case?
13. Dr.Basma ,FM,SCU,2012-2013
Ask your selfAsk your self
Is she pregnant ?
Intra uterine or ectopic pregnancy ?
Viable or not viable fetus ?
How to mange?
14. Dr.Basma ,FM,SCU,2012-2013
Is she pregnantIs she pregnant??
History of amenorrheaHistory of amenorrhea
LabLab
B hCG test
S.Progesterone
UltrasoundUltrasound
15. Dr.Basma ,FM,SCU,2012-2013
Beta HCG
hCG is detectable in the serum of
approximately :
5% of patients 8 days after conception
in more than 98% of patients by day 11.
16. Dr.Basma ,FM,SCU,2012-2013
according to the American Pregnancy Association. Most urine tests have a
detection level of 25 mIU/mL to indicate pregnancy
According to the National Women's Health Information Center,
90 percent of women who were pregnant got a positive urine test on the
first day of a missed pregnancy.
This goes up to 97 percent one weekone week after the first missed period.
17. Dr.Basma ,FM,SCU,2012-2013
Ask your selfAsk your self
Is she pregnant ?
Intra uterine or ectopic pregnancy ?
Viable or not viable fetus ?
If not vaible ……..which type?
21. Dr.Basma ,FM,SCU,2012-2013
True gestational sacTrue gestational sac must bemust be differentiated fromdifferentiated from
pseudo sacpseudo sac
Embryonic Vesicle (Primary yolk sac
Round or oval.
Double ring )Ring of decidualized
endometrium.
Fundal or mid-portion of the uterus.
May occasionally implant low down in the
uterine cavity.
22. Dr.Basma ,FM,SCU,2012-2013
Double-decidual sign (5 weeks menstrual age). The decidua vera (dv) can be discerned
from the decidua capsularis (dc) and chorion laeve surrounding the gestational sac. A
small subchorionic hemorrhage(*) is present between the unapposed layers of
deciduvera.
23. Dr.Basma ,FM,SCU,2012-2013
The "Double Decidual
Sign"consists of two
echogenic rings
surrounding the
hypoechoic gestational
sac.
The inner ring represents
the chorion, embryonic
disc and decidua
capsularis (*). The outer
ring represents the
decidua parietalis (**).
28. Dr.Basma ,FM,SCU,2012-2013
Single decidul ring ( pseudo sac)
This may be due to a decidual cast and fluid in the endometrial cavity. This appearance can be found in
the presence of an ectopic pregnancy
39. Dr.Basma ,FM,SCU,2012-2013
If early pregnancy problems…. Urine B-hCG +
AScan
Intra-uterine pregnancy …….GOOD
No Intra-uterine gestation Seen…… serum B-
hCG + TVS.
with serum B-hCG of 1500-2000 ml I.U/ml Intra
uterine gestation should be seen using TVS……
otherwise suspect Ectopic pregnancy
40. Dr.Basma ,FM,SCU,2012-2013
Serum Human Chorionic
Gonadotropin
Discriminatory zone: B-hCG level at which
Gestational sac of IU pregnancy should be
seen with U/S confirming IU pregnancy and
essentially R/O EP.
Intrauterine sac should be visulized:
TVUS B-hCG level >= 1,000-2,000 IU/L
TAUS B-hCG level >= 6,500 IU/L
In Singleton pregnancy
41. Dr.Basma ,FM,SCU,2012-2013
Serum Human Chorionic
Gonadotropin
Rise in B-hCG levels of at least 66% in 2 days or 100% in 3
days is consistent with normal pregnancy.
Minimum increase is 53%
A rise less than this(<53%) is inconclusive because it seen in:
1. 15 % of normal pregnancy
2. EP
3. Nonviable IU pregnancy
– Falling hCG level suggest non viable IU pregnancy.
< 7 week
GA
42. Dr.Basma ,FM,SCU,2012-2013
ultrasonographic diagnosis
Definitive ultrasonographic diagnosis of an ectopic pregnancy is made in
only about 20% of cases, when an extrauterine pregnancy is clearly
identified (ie, an extrauterine gestational sac with a yolk sac or fetal pole is
visualized).
numerous findings that are highly suggestive of ectopic pregnancy,
including
1. an empty uterus in a patient with a β-hCG level above the discriminatory
zone,
2. an adnexal mass other than a simple cyst .
3. echogenic fluid in the cul-de-sac, or anything more than a small amount of
fluid in the cul-de-sac.
44. Dr.Basma ,FM,SCU,2012-2013
Ultrasound sign
A tubal ring is a thick-walled cystic structure in the adnexa,
independent of the ovary and uterus, and is highly predictive
of ectopic pregnancy
It can sometimes be confused with a corpus luteum cyst when
the ovary is not well visualized.
The corpus luteum cyst wall tends to be thinner and less
echogenic than the endometrium, and the cyst tends to contain
clear fluid
When surrounded by free fluid, it can sometimes be confused
with a hemorrhagic ovarian cyst.[17]
46. Dr.Basma ,FM,SCU,2012-2013
Uterus outlined red, uterine lining green
Tubal ectopic pregnancy yellow
Fluid in uterus at blue circle is a "pseudosac"
Looks like early pregnancy sac, but is not
47. Dr.Basma ,FM,SCU,2012-2013
The most definitive
sonographic sign of
ectopic pregnancy is the
visualization of an
extrauterine gestational
sac containing a yolk
sac, embryo or fetal
heart beat
ectopicUterus
50. Dr.Basma ,FM,SCU,2012-2013
Normal US Findings
Embryo (black arrow); amnion (small arrow) does not fuse
with chorion (large arrow) until 12-16wks gestation.
52. Dr.Basma ,FM,SCU,2012-2013
Ask your selfAsk your self
Is she pregnant ?
Intra uterine or ectopic pregnancy ?
Viable or not viable fetus ?
If not vaible ……..which type?
55. Dr.Basma ,FM,SCU,2012-2013
Signs suggestive of abnormal embryonic developmentSigns suggestive of abnormal embryonic development
include a gestational sac greater than 10 mm10 mm in diameter without a visible
yolk sac
gestational sac greater than 18 mm18 mm in diameter without a fetal pole
a collapsed gestational sac
Additionally, when the difference between the mean sac diameter and
crown rump length (CRL) is less than 5mm5mm, there is a significant risk of
spontaneous abortion.
Other signs associated with a poor prognosis include the absence of a fetal
heart beat in an embryo with a CRL of at least 5 mm5 mm
a fetal heart beat less than 90 beats90 beats per minute.
56. Dr.Basma ,FM,SCU,2012-2013
Serum Human Chorionic
Gonadotropin
Rise in B-hCG levels of at least 66% in 2 days or 100% in 3
days is consistent with normal pregnancy.
Minimum increase is 53%
A rise less than this(<53%) is inconclusive because it seen in:
1. 15 % of normal pregnancy
2. EP
3. Nonviable IU pregnancy
– Falling hCG level suggest non viable IU pregnancy.
< 7 week
GA
62. Dr.Basma ,FM,SCU,2012-2013
Ask your selfAsk your self
Is she pregnant ?
Intra uterine or ectopic pregnancy ?
Viable or not viable fetus ?
Management ?
68. Dr.Basma ,FM,SCU,2012-2013
Management
Expectant management (wait and see) is highly effective for
the treatment of incomplete abortion, follow up by b hcgincomplete abortion, follow up by b hcg 8080
percent drop in the β-hCG level one week following the
passage of tissue confirms completion.
misoprostol and uterine aspiration are more effective for the
management of anembryonic gestationanembryonic gestation and embryonicembryonic
demise.demise.
69. Dr.Basma ,FM,SCU,2012-2013
Misoprostol in a dose of 800 mcg administered vaginally is
effective and well-tolerated.
Cramping and bleeding typically occur within two to six
hours of misoprostol insertion, with the most sever symptoms
resolving in about three to five hours.
Pretreatment with a nonsteroidal anti-infammatory drug
before administering is helpful adverse effects of fever, chills,
and severe cramping
&lt;number&gt;
In the left-hand scan, we see a thin endometrial “stripe”. This ultrasound would tend to rule out retained products of conception as a cause of continued bleeding. Other causes could be infection or a hypotrophic endometrium. This contrasts with the ultrasound on the lower right, in which the endometrial “stripe” is thickened. Remember that after a medical abortion, a thickened “stripe” is a normal finding and intervention is only necessary if clinically indicated.