This review examines the effectiveness of magnesium sulfate given to women at term to protect the fetus from brain injury and neurodevelopmental disabilities like cerebral palsy. The review included one randomized controlled trial with 135 women with mild preeclampsia at term. The trial found no significant differences in infant outcomes like Apgar scores or gestational age between the magnesium sulfate and placebo groups. Maternal side effects were more common with magnesium sulfate, but severe side effects causing treatment cessation were similar between groups. Larger trials are still needed to determine if magnesium sulfate provides neuroprotection for infants when administered at term.
The document discusses evidence that magnesium sulfate administered to mothers at risk of preterm birth reduces the risk of cerebral palsy in infants. Several large randomized controlled trials and meta-analyses involving over 15,000 women found magnesium sulfate decreased the risk of cerebral palsy without increasing mortality. The number needed to treat to prevent one case of cerebral palsy is estimated at 63 women. The document also describes a modified magnesium sulfate neuroprotection protocol used at Riverside Hospital for imminent preterm deliveries between 23 and 33 weeks.
This document summarizes the current literature on using magnesium sulfate for cerebral palsy prevention. It defines cerebral palsy and reviews studies showing magnesium sulfate may have neuroprotective effects by blocking calcium influx and glutamate receptors during hypoxic-ischemic injury. Several postnatal and antenatal studies are summarized, with meta-analyses finding magnesium sulfate reduces the risk of cerebral palsy, especially in very preterm infants under 30 weeks gestation. However, the evidence remains unclear and larger trials are still needed to establish efficacy and optimal dosing protocols.
How to relax before and after an RSI intubationscanFOAM
A presentation by Malin Johnsson Fagerlund at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All available content from SSAI2017: https://scanfoam.org/ssai2017/
Delivered in collaboration between scanFOAM, SSAI & SFAI.
Optimizing The outcome of Threatened Abortion Dr Sharda Jain Lifecare Centre
- Around 70% of conceptions are lost prior to live birth, with 30% lost before implantation and 30% after implantation but before a missed period. Threatened abortion refers to vaginal bleeding or pain, or both, in early pregnancy when the cervical os remains closed.
- Studies have shown that counseling reduces adverse psychological effects from miscarriage. Treatment with dydrogesterone has been shown to reduce pregnancy loss in threatened abortion during the first trimester compared to placebo or no treatment. However, treatment with vaginal progesterone compared to placebo appears to have little effect on reducing miscarriage rates.
- Meta-analyses of multiple randomized controlled trials found that treatment with dydrogesterone for threatened miscarriage significantly reduced miscarriage
This document summarizes a panel discussion on the management of IVF pregnancies conducted by Delhi ISAR, Advance Fertility and Gynaecology Centre, and Madhukar Rainbow Group of Hospitals. The panelists provided expert opinions on topics like the choice of ART treatment, number of embryos to transfer, luteal phase support, anomaly screening, reduction of higher order multiples, antenatal follow-up, prevention of preterm labor, use of antenatal steroids, and delivery timing in twin pregnancies. The document emphasizes that IVF pregnancies require special care and management.
Invited Lecture delivered by Dr Sujoy Dasgupta in National Youth Conference, held at Patna in August 2019. This session was sponsored by Bharat Serum and Vaccines
The document discusses evidence that magnesium sulfate administered to mothers at risk of preterm birth reduces the risk of cerebral palsy in infants. Several large randomized controlled trials and meta-analyses involving over 15,000 women found magnesium sulfate decreased the risk of cerebral palsy without increasing mortality. The number needed to treat to prevent one case of cerebral palsy is estimated at 63 women. The document also describes a modified magnesium sulfate neuroprotection protocol used at Riverside Hospital for imminent preterm deliveries between 23 and 33 weeks.
This document summarizes the current literature on using magnesium sulfate for cerebral palsy prevention. It defines cerebral palsy and reviews studies showing magnesium sulfate may have neuroprotective effects by blocking calcium influx and glutamate receptors during hypoxic-ischemic injury. Several postnatal and antenatal studies are summarized, with meta-analyses finding magnesium sulfate reduces the risk of cerebral palsy, especially in very preterm infants under 30 weeks gestation. However, the evidence remains unclear and larger trials are still needed to establish efficacy and optimal dosing protocols.
How to relax before and after an RSI intubationscanFOAM
A presentation by Malin Johnsson Fagerlund at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All available content from SSAI2017: https://scanfoam.org/ssai2017/
Delivered in collaboration between scanFOAM, SSAI & SFAI.
Optimizing The outcome of Threatened Abortion Dr Sharda Jain Lifecare Centre
- Around 70% of conceptions are lost prior to live birth, with 30% lost before implantation and 30% after implantation but before a missed period. Threatened abortion refers to vaginal bleeding or pain, or both, in early pregnancy when the cervical os remains closed.
- Studies have shown that counseling reduces adverse psychological effects from miscarriage. Treatment with dydrogesterone has been shown to reduce pregnancy loss in threatened abortion during the first trimester compared to placebo or no treatment. However, treatment with vaginal progesterone compared to placebo appears to have little effect on reducing miscarriage rates.
- Meta-analyses of multiple randomized controlled trials found that treatment with dydrogesterone for threatened miscarriage significantly reduced miscarriage
This document summarizes a panel discussion on the management of IVF pregnancies conducted by Delhi ISAR, Advance Fertility and Gynaecology Centre, and Madhukar Rainbow Group of Hospitals. The panelists provided expert opinions on topics like the choice of ART treatment, number of embryos to transfer, luteal phase support, anomaly screening, reduction of higher order multiples, antenatal follow-up, prevention of preterm labor, use of antenatal steroids, and delivery timing in twin pregnancies. The document emphasizes that IVF pregnancies require special care and management.
Invited Lecture delivered by Dr Sujoy Dasgupta in National Youth Conference, held at Patna in August 2019. This session was sponsored by Bharat Serum and Vaccines
Progesterone for luteal phase support in IVF cyclesHesham Al-Inany
Luteal phase support is essential for IVF cycles. Progesterone has many forms and modalities: which to use? this talk is an attempt to answer this question
This document provides an update on poor ovarian response and approaches to improving outcomes for women with poor ovarian reserve undergoing IVF treatment. The key points summarized are:
1) The PRIMA study found no difference in pregnancy outcomes between a mild ovarian stimulation protocol using 150 IU of FSH daily versus a conventional stimulation protocol using 450 IU of HMG daily for women with poor ovarian reserve, despite the mild protocol requiring fewer days of stimulation and lower gonadotropin doses.
2) While increasing gonadotropin doses does not improve pregnancy rates, supplementation with LH during stimulation may provide benefits for women with poor ovarian reserve based on prior studies.
3) A new approach called "dual stimulation"
Dr. Somendra shukla is a one of the best Pediatrician & neonatologist at Gurgaon.
He has vast expierence of 9 yrs in neonatology & pediatrics. He has cleared the prestigious Diplomate of National Board (DNB) and royal college of pediatrics, london (MRCPCH) examinations in pediatrics. He has worked and honed up her skills with some of the top corporates institutes of India such as Fortis hospital, moolchand medcity and paras hospital. He has also done his Fellowship in neonatology awarded by prestigious National neonatology forum of India.He is a member of IAP and NNF and has attended various seminars and workshops and has presented several papers in various national conferences and conducted CMEs. He is an expert in newborn intensive care including care of ventilated and extremely low birth weight babies (<1000g><750g). His area of interest are childhood vaccination, growth and development and childhood asthma.
Dr Sujoy Dasgupta was invited to deliver a lecture at BOGSCON (The Annual Conference of Bengal Obstetric and Gynaecological Society) held at Kolkata in December 2019
Fertility preservation in addressing women's biological clock and decreasing ...Matheus Roque
This was presented during the Insight 17' event - Coimbatore / India (October 2017). Some questions were discussed concerning the Social Egg Freezing: 1. Why?; 2. Is it effective?; 3. Is it cost-effective?; 4. When it should be done? ; 5. Are the women the same in different countries?
This document discusses repeated doses of antenatal corticosteroids for women at risk of preterm birth. It provides background on the benefits of corticosteroids in reducing preterm birth complications. While repeated doses are associated with better neonatal lung function, there is no significant reduction in severe respiratory distress or brain injuries. Repeated doses may cause intrauterine growth restriction. The document recommends repeating a single rescue dose or course only if 7 days have passed since the initial dose and the woman remains at risk of preterm labor.
Since the first formal description of LPD in 1949 as a possible cause of infertility and recurrent miscarriage by Jones. Innumerable investigations have been undertaken in an effort to verify its existence or to characterize its pathophysiology, diagnosis, and treatment. The consensus of the literature is that LPD does exist and that its cause is multifactorial like abnormal folliculogenesis, inadequate LH surge,inadequate secretion of progesterone by the corpus luteum, aberrant end-organ response by the endometrium.
In this presentation it was discussed the effects of controlled ovarian stimulation (COS) over the endometrium. Moreover, it was discussed the pros and cons of the freeze-all policy.
This document provides information on various forms of emergency contraception. It discusses the Yuzpe method, levonorgestrel, copper IUDs, and ulipristal acetate. For each method, it covers mechanisms of action, effectiveness, appropriate usage, side effects, limitations, and clinical considerations. The document aims to educate health professionals on the options available for emergency contraception and factors to consider when recommending a method.
The document discusses total cellular wellness and natural growth factor (NGF) supplements. It describes how NGF can regenerate nerve cells by stimulating them to return to the growth phase. The supplement contains bird nest extract and other natural ingredients like purple chokeberry and bacopa. It lists several benefits of NGF including stimulating nerve growth factors, helping with neurodegenerative diseases and memory enhancement, and regulating the immune system. The supplement may help healthy people, those with mild neurological conditions, and those with serious conditions. Global demand for nerve repair treatments is projected to reach $18.2 billion by 2024.
Coasting involves withholding gonadotropins during IVF stimulation to prevent ovarian hyperstimulation syndrome (OHSS) while still allowing larger follicles to develop. It works by reducing the population of granulosa cells and related growth factors linked to OHSS. While some studies found coasting reduces OHSS and cycle cancellations without harming outcomes, others noted potential risks to endometrial receptivity and embryo quality if coasting lasts too long. The document discusses strategies for determining when to start coasting and evaluating its effectiveness and risks in different contexts.
Dr. r santos evidence-based contraceptive methodsrigelsuarez
Based on the graph, rear entry coital position is associated with the highest risk of preterm delivery with PROM.
The graph shows that rear entry position has the highest percentage of preterm deliveries with PROM compared to female superior, male superior and side by side positions.
Role of antioxidants in female infertility Dr. Jyoti AgarwalLifecare Centre
Role of antioxidants in female infertility Dr. Jyoti Agarwal
3 Concepts
Oxygen toxicity is an inherent challenge to aerobic life
Oxygen is essential for life.
Excess oxygen can have harmful effects.
When oxygen is metabolised in the body , it produces substances called FREE RADICALS which damage our cells.
Antenatal corticosteroids are effective in reducing risks for preterm infants when administered to mothers at risk of preterm birth between 24-34 weeks of gestation. A single course of corticosteroids, such as betamethasone or dexamethasone, significantly reduces the risks of respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis and improves neonatal outcomes with no significant maternal risks. While a single repeat or rescue course may provide additional benefits, multiple courses are not recommended due to potential risks of impaired fetal growth and cerebral palsy.
This document outlines a 4G ovarian stimulation protocol. It discusses mono follicular versus multifollicular development and the use of gonadotropins, clomiphene citrate, and low-dose FSH for ovulation induction. It also reviews luteal phase support strategies and cost considerations for different stimulation protocols. The document presents data from clinical trials comparing stimulation methods and concludes that gonadotropins are the most effective for ovulation induction and IVF, though cost must also be considered.
This document summarizes evidence on the use of progesterone to prevent preterm birth. It finds that progesterone reduces the risk of preterm birth before 37 weeks in women with a prior preterm delivery or short cervix. Progesterone may also reduce complications for infants born preterm to mothers receiving it. However, progesterone does not prevent early preterm birth in twin or triplet pregnancies. No long-term harms were seen in children exposed to progesterone prenatally.
This review assessed the effectiveness of magnesium sulphate given to women at term as a neuroprotective agent for the fetus. The review included one randomized controlled trial involving 135 women with mild pre-eclampsia. The trial found no significant differences in infant outcomes like Apgar scores or gestational age between the magnesium sulphate and placebo groups. Mothers receiving magnesium sulphate reported more side effects like feeling warm and flushed. More research is needed to determine if magnesium sulphate provides neuroprotection for infants of mothers at term.
This Cochrane review evaluated the effects of magnesium sulfate treatment for women at risk of preterm birth to protect the fetus. The review found that magnesium sulfate treatment significantly reduced the risk of cerebral palsy in preterm infants and substantial gross motor dysfunction. There was no significant effect on pediatric mortality or other neurological impairments. Magnesium sulfate treatment was associated with minor side effects in mothers but no significant effects on major maternal complications. The review concluded that magnesium sulfate treatment for women at risk of preterm birth provides neuroprotection for the fetus.
This review examined the potential neuroprotective effects of giving creatine supplements to pregnant women. The review found no randomized controlled trials that tested creatine for this purpose. Creatine plays a role in energy production in cells and animal studies suggest it may protect the developing fetal brain from injury. However, without clinical trials in humans, the review was unable to determine if creatine supplementation during pregnancy could reduce the risk of brain injury for the fetus or neurodevelopmental problems after birth. More research is needed in the form of randomized trials before conclusions can be drawn.
Progesterone for luteal phase support in IVF cyclesHesham Al-Inany
Luteal phase support is essential for IVF cycles. Progesterone has many forms and modalities: which to use? this talk is an attempt to answer this question
This document provides an update on poor ovarian response and approaches to improving outcomes for women with poor ovarian reserve undergoing IVF treatment. The key points summarized are:
1) The PRIMA study found no difference in pregnancy outcomes between a mild ovarian stimulation protocol using 150 IU of FSH daily versus a conventional stimulation protocol using 450 IU of HMG daily for women with poor ovarian reserve, despite the mild protocol requiring fewer days of stimulation and lower gonadotropin doses.
2) While increasing gonadotropin doses does not improve pregnancy rates, supplementation with LH during stimulation may provide benefits for women with poor ovarian reserve based on prior studies.
3) A new approach called "dual stimulation"
Dr. Somendra shukla is a one of the best Pediatrician & neonatologist at Gurgaon.
He has vast expierence of 9 yrs in neonatology & pediatrics. He has cleared the prestigious Diplomate of National Board (DNB) and royal college of pediatrics, london (MRCPCH) examinations in pediatrics. He has worked and honed up her skills with some of the top corporates institutes of India such as Fortis hospital, moolchand medcity and paras hospital. He has also done his Fellowship in neonatology awarded by prestigious National neonatology forum of India.He is a member of IAP and NNF and has attended various seminars and workshops and has presented several papers in various national conferences and conducted CMEs. He is an expert in newborn intensive care including care of ventilated and extremely low birth weight babies (<1000g><750g). His area of interest are childhood vaccination, growth and development and childhood asthma.
Dr Sujoy Dasgupta was invited to deliver a lecture at BOGSCON (The Annual Conference of Bengal Obstetric and Gynaecological Society) held at Kolkata in December 2019
Fertility preservation in addressing women's biological clock and decreasing ...Matheus Roque
This was presented during the Insight 17' event - Coimbatore / India (October 2017). Some questions were discussed concerning the Social Egg Freezing: 1. Why?; 2. Is it effective?; 3. Is it cost-effective?; 4. When it should be done? ; 5. Are the women the same in different countries?
This document discusses repeated doses of antenatal corticosteroids for women at risk of preterm birth. It provides background on the benefits of corticosteroids in reducing preterm birth complications. While repeated doses are associated with better neonatal lung function, there is no significant reduction in severe respiratory distress or brain injuries. Repeated doses may cause intrauterine growth restriction. The document recommends repeating a single rescue dose or course only if 7 days have passed since the initial dose and the woman remains at risk of preterm labor.
Since the first formal description of LPD in 1949 as a possible cause of infertility and recurrent miscarriage by Jones. Innumerable investigations have been undertaken in an effort to verify its existence or to characterize its pathophysiology, diagnosis, and treatment. The consensus of the literature is that LPD does exist and that its cause is multifactorial like abnormal folliculogenesis, inadequate LH surge,inadequate secretion of progesterone by the corpus luteum, aberrant end-organ response by the endometrium.
In this presentation it was discussed the effects of controlled ovarian stimulation (COS) over the endometrium. Moreover, it was discussed the pros and cons of the freeze-all policy.
This document provides information on various forms of emergency contraception. It discusses the Yuzpe method, levonorgestrel, copper IUDs, and ulipristal acetate. For each method, it covers mechanisms of action, effectiveness, appropriate usage, side effects, limitations, and clinical considerations. The document aims to educate health professionals on the options available for emergency contraception and factors to consider when recommending a method.
The document discusses total cellular wellness and natural growth factor (NGF) supplements. It describes how NGF can regenerate nerve cells by stimulating them to return to the growth phase. The supplement contains bird nest extract and other natural ingredients like purple chokeberry and bacopa. It lists several benefits of NGF including stimulating nerve growth factors, helping with neurodegenerative diseases and memory enhancement, and regulating the immune system. The supplement may help healthy people, those with mild neurological conditions, and those with serious conditions. Global demand for nerve repair treatments is projected to reach $18.2 billion by 2024.
Coasting involves withholding gonadotropins during IVF stimulation to prevent ovarian hyperstimulation syndrome (OHSS) while still allowing larger follicles to develop. It works by reducing the population of granulosa cells and related growth factors linked to OHSS. While some studies found coasting reduces OHSS and cycle cancellations without harming outcomes, others noted potential risks to endometrial receptivity and embryo quality if coasting lasts too long. The document discusses strategies for determining when to start coasting and evaluating its effectiveness and risks in different contexts.
Dr. r santos evidence-based contraceptive methodsrigelsuarez
Based on the graph, rear entry coital position is associated with the highest risk of preterm delivery with PROM.
The graph shows that rear entry position has the highest percentage of preterm deliveries with PROM compared to female superior, male superior and side by side positions.
Role of antioxidants in female infertility Dr. Jyoti AgarwalLifecare Centre
Role of antioxidants in female infertility Dr. Jyoti Agarwal
3 Concepts
Oxygen toxicity is an inherent challenge to aerobic life
Oxygen is essential for life.
Excess oxygen can have harmful effects.
When oxygen is metabolised in the body , it produces substances called FREE RADICALS which damage our cells.
Antenatal corticosteroids are effective in reducing risks for preterm infants when administered to mothers at risk of preterm birth between 24-34 weeks of gestation. A single course of corticosteroids, such as betamethasone or dexamethasone, significantly reduces the risks of respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis and improves neonatal outcomes with no significant maternal risks. While a single repeat or rescue course may provide additional benefits, multiple courses are not recommended due to potential risks of impaired fetal growth and cerebral palsy.
This document outlines a 4G ovarian stimulation protocol. It discusses mono follicular versus multifollicular development and the use of gonadotropins, clomiphene citrate, and low-dose FSH for ovulation induction. It also reviews luteal phase support strategies and cost considerations for different stimulation protocols. The document presents data from clinical trials comparing stimulation methods and concludes that gonadotropins are the most effective for ovulation induction and IVF, though cost must also be considered.
This document summarizes evidence on the use of progesterone to prevent preterm birth. It finds that progesterone reduces the risk of preterm birth before 37 weeks in women with a prior preterm delivery or short cervix. Progesterone may also reduce complications for infants born preterm to mothers receiving it. However, progesterone does not prevent early preterm birth in twin or triplet pregnancies. No long-term harms were seen in children exposed to progesterone prenatally.
This review assessed the effectiveness of magnesium sulphate given to women at term as a neuroprotective agent for the fetus. The review included one randomized controlled trial involving 135 women with mild pre-eclampsia. The trial found no significant differences in infant outcomes like Apgar scores or gestational age between the magnesium sulphate and placebo groups. Mothers receiving magnesium sulphate reported more side effects like feeling warm and flushed. More research is needed to determine if magnesium sulphate provides neuroprotection for infants of mothers at term.
This Cochrane review evaluated the effects of magnesium sulfate treatment for women at risk of preterm birth to protect the fetus. The review found that magnesium sulfate treatment significantly reduced the risk of cerebral palsy in preterm infants and substantial gross motor dysfunction. There was no significant effect on pediatric mortality or other neurological impairments. Magnesium sulfate treatment was associated with minor side effects in mothers but no significant effects on major maternal complications. The review concluded that magnesium sulfate treatment for women at risk of preterm birth provides neuroprotection for the fetus.
This review examined the potential neuroprotective effects of giving creatine supplements to pregnant women. The review found no randomized controlled trials that tested creatine for this purpose. Creatine plays a role in energy production in cells and animal studies suggest it may protect the developing fetal brain from injury. However, without clinical trials in humans, the review was unable to determine if creatine supplementation during pregnancy could reduce the risk of brain injury for the fetus or neurodevelopmental problems after birth. More research is needed in the form of randomized trials before conclusions can be drawn.
This review examined whether giving creatine to women during pregnancy could help protect the fetus's brain. The review found no randomized controlled trials that tested creatine for this purpose. Animal studies suggest creatine may provide neuroprotection, but no human trials have been conducted. High-quality randomized trials are needed to determine if creatine is safe and effective for preventing fetal brain injury.
This Cochrane review examines whether magnesium sulfate administered to women at term protects the fetus from brain injury. The review included one small randomized controlled trial involving 135 women with mild preeclampsia. The trial found no significant differences in outcomes like Apgar scores or gestational age between infants whose mothers received magnesium sulfate or placebo. Maternal side effects like warmth and flushing were more common with magnesium sulfate, but serious side effects causing treatment cessation were not. Larger trials are still needed to determine if magnesium sulfate provides neuroprotective benefits for term infants.
This Cochrane review examines the effects of magnesium sulfate given to women at risk of preterm birth to protect the fetus's brain. The review found that magnesium sulfate significantly reduced the risk of cerebral palsy in preterm infants by 32% and reduced substantial gross motor dysfunction by 39%. No significant effects were found for pediatric mortality or other neurological impairments. Magnesium sulfate was found to have minor side effects for mothers but no significant effects on major maternal complications. The review concludes that magnesium sulfate has a established neuroprotective role for preterm fetuses.
1) Magnesium sulfate has been shown to provide neuroprotective effects for extremely premature infants by reducing cerebral injury and cell death.
2) While some studies found magnesium sulfate to be neuroprotective, others did not find sustainable effects, so more randomized studies were conducted.
3) A Cochrane review of 5 randomized trials found magnesium sulfate significantly reduced the risk of cerebral palsy in premature infants without increasing mortality risks for mother or infant.
This study aims to assess whether giving magnesium sulfate compared to placebo to women at risk of preterm birth between 30-34 weeks reduces the risk of death or cerebral palsy in children at two years. The study will randomly assign over 1600 women to receive either magnesium sulfate or placebo. The primary outcome measured will be death or cerebral palsy in children at two years. Previous studies have shown magnesium sulfate may reduce the risk of cerebral palsy in preterm infants, but the benefits at later gestational ages are uncertain, motivating this clinical trial.
This editorial discusses a recent randomized controlled trial that evaluated the use of bortezomib plus melphalan and prednisone compared to melphalan and prednisone alone for the initial treatment of multiple myeloma in patients who were not eligible for stem cell transplantation. The trial found that the combination of bortezomib provided superior outcomes, including higher response rates and longer duration of response. However, the editorial cautions that to effectively apply these results, comparisons need to be made to other available treatment options, long-term outcomes need to be evaluated, and toxic effects on quality of life considered. Overall progress is being made in multiple myeloma treatment, but further research is still needed.
This Cochrane review summarizes the current evidence on using creatine supplementation during pregnancy to protect the developing fetus's brain. The review found no randomized controlled trials examining the effects of creatine supplementation for fetal neuroprotection. While animal studies suggest creatine may protect the fetal brain, high-quality randomized trials are still needed to establish the safety and efficacy of creatine supplementation during human pregnancy. Such trials should evaluate both short- and long-term maternal and infant outcomes, including rates of neurodevelopmental disabilities in childhood.
This study protocol describes a randomized controlled trial to assess whether magnesium sulfate compared to placebo administered to women at risk of preterm birth between 30-34 weeks reduces the risk of death or cerebral palsy in children at two years of age. The trial will randomize over 1676 women to receive either magnesium sulfate or placebo by IV infusion within 24 hours of planned or expected preterm birth. The primary outcome will be death or cerebral palsy in children at two years of age. The trial aims to provide evidence on whether the neuroprotective benefits of magnesium sulfate seen at earlier gestations apply at 30-34 weeks.
Guía ISUOG: Ecografía del primer trimestreTony Terrones
This document provides guidelines for performing first trimester fetal ultrasounds from the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG). It recommends that routine first trimester ultrasounds should be performed between 11-13+6 weeks gestation to confirm viability, accurately date the pregnancy, determine fetal number, and assess gross anatomy. Ultrasounds should be performed by trained practitioners using appropriate equipment and following standardized examination and documentation procedures. Measurements such as crown-rump length are recommended to accurately assess gestational age. Safety considerations and limitations of first trimester ultrasounds are also discussed.
The review evaluated the effectiveness of ACE inhibitors (ACEi) and angiotensin receptor blockers (ARB) for adults with early stage chronic kidney disease without diabetes. Four randomized controlled trials with 2,177 participants were included. Low to moderate quality evidence from two studies found that ACEi had no impact on mortality or cardiovascular events compared to placebo in people with stage 3 kidney disease. One study found no difference in risk of end-stage kidney disease between ACEi and placebo in people with eGFR >45 mL/min/1.74 m2. No published studies directly compared ARB to placebo. In summary, there is currently insufficient evidence to determine the effectiveness of ACEi or ARB for patients
Prenatal testing consists of screening and diagnosis to detect problems with the pregnancy as early as possible. Screening can detect issues like neural tube defects, chromosome abnormalities, and genetic disorders. Prenatal diagnosis allows for medical treatment, decisions about continuing the pregnancy, and preparation if issues are diagnosed. Methods include invasive tests like amniocentesis and chorionic villus sampling, and non-invasive tests like ultrasound and maternal serum screening. Ethical issues include the impact on women's autonomy and sense of control, as well as disability rights and social justice concerns. Most religions address when termination of pregnancy is allowed, such as when the mother's life is endangered or serious fetal anomalies exist, with Islam generally permitting termination before 120 days
Health Care Quality for an Active Later Life University of Exeter Medical SchoolAge UK
This document summarizes key findings from a report on health care quality for older adults in England from 2005 to 2012. It highlights trends in the aging population and increasing life expectancy. It also examines the prevalence of chronic diseases and functional limitations in older age, as well as health risks and quality of treatment for common conditions. The report concludes that while treatment for diseases like heart disease and cancer have greatly improved survival, there is still room for enhancing prevention efforts and ensuring high quality coordinated care for older patients.
This document provides clinical practice guidelines for the diagnosis and treatment of hyperprolactinemia from The Endocrine Society. It was developed by an international task force using the GRADE framework to formulate evidence-based recommendations. The guidelines cover evaluating the cause of hyperprolactinemia, managing drug-induced cases, treating prolactinomas in nonpregnant and pregnant patients, and addressing resistant or malignant prolactinomas. The task force created strong and weak recommendations based on the available evidence to provide guidance to healthcare professionals in diagnosing and managing hyperprolactinemia.
Effects of Changing Branched-Chain Amino Acid and Insulin Levels In Vitro on ...Tristan Demuth
This document summarizes a study examining the effects of changing branched-chain amino acid and insulin levels on developing pre-implantation embryos in vitro. The study aims to better understand how early embryos interact with their environment during pregnancy and investigate whether reducing amino acid and insulin levels is sufficient to cause embryos to adapt their development, potentially predisposing them to disease later in life. The results showed that depleting these nutrient levels in vitro did not cause embryos to adapt their development by the late blastocyst stage. Further experiments are needed to understand other ways embryos may detect poor maternal environments early in development.
Effects of Changing Branched-Chain Amino Acid and Insulin Levels In Vitro on ...Tristan Demuth
This document summarizes a study examining the effects of changing branched-chain amino acid and insulin levels on developing pre-implantation embryos in vitro. The study aims to better understand how early embryos interact with their environment during pregnancy and investigate whether reducing amino acid and insulin levels is sufficient to cause embryos to adapt their development, indicating potential predisposition to disease later in life. The results showed that depleting these nutrient levels in vitro did not cause embryonic development adaptation by the late blastocyst stage. Further experiments are needed to understand other ways embryos may detect poor maternal environments early in development.
This document provides an overview of cancer screening. It discusses the history and evolution of screening for breast, prostate, and colon cancers. New screening approaches like PSA tests and mammography are analyzed. Guidelines and recommendations for cancer screening have changed over time and continue to be controversial. Technology has impacted screening by enabling new modalities like virtual colonoscopy. Experts evaluate screening programs and make recommendations, but determining the right approach remains challenging.
Interventions for promoting smoking cessation duringGeorgi Daskalov
This Cochrane review analyzed 72 randomized controlled trials evaluating interventions to promote smoking cessation during pregnancy. The interventions led to a 6% reduction in the risk of continued smoking in late pregnancy compared to control groups. Subgroup analyses found that more intensive interventions and those using behavioral counseling were most effective. The interventions also increased mean birth weight and reduced the risk of low birthweight. However, they did not significantly impact other perinatal outcomes such as preterm birth or perinatal deaths. The review concluded that smoking cessation interventions during pregnancy can improve smoking abstinence and infant birth weight outcomes.
El plan promueve la inclusión, la igualdad y el respeto de los derechos humanos en materia de salud sexual y salud reproductiva en Ecuador. Establece lineamientos estratégicos y acciones para mejorar indicadores prioritarios como la mortalidad materna, el uso de anticonceptivos y la fecundidad entre adolescentes. Además, articula la gestión del sistema de salud para producir conocimiento sobre este tema e implementar estrategias que logren modificar dichos indicadores.
Este documento describe los mecanismos del parto, incluyendo la situación, presentación, actitud y variedad de posición del feto, los planos de Hodge, el desprendimiento y rotación externa de la cabeza fetal, y los signos de descenso de la placenta.
Este documento presenta una guía de práctica clínica sobre hipertensión arterial desarrollada por el Ministerio de Salud Pública del Ecuador. La guía provee recomendaciones sobre prevención, diagnóstico, tratamiento y seguimiento de pacientes hipertensos. El objetivo es asistir a profesionales de la salud en la toma de decisiones sobre esta condición. La guía fue adaptada de lineamientos internacionales mediante un proceso que incluyó revisión de evidencia y consenso de expertos.
Este documento presenta el Modelo de gestión de aplicación del consentimiento informado en la práctica asistencial, de acuerdo con el Acuerdo Ministerial 5316. Explica la importancia del consentimiento informado, los modelos de relación médico-paciente, y extractos de normas relacionadas con el consentimiento informado en Ecuador. Además, resume los objetivos, condiciones y responsables del proceso de consentimiento informado, y provee un modelo de formulario de consentimiento informado escrito.
Gp tuberculosis 1 / https://www.salud.gob.ec/guias-de-practica-clinica/Jaime Zapata Salazar
Guía de práctica clínica Tuberculosis
Prevención, diagnóstico , tratamiento y control de Tuberculosis
https://www.salud.gob.ec/guias-de-practica-clinica/
Esta guía de práctica clínica del Ministerio de Salud Pública del Ecuador tiene como objetivo proporcionar recomendaciones para la prevención, diagnóstico y tratamiento de la enfermedad renal crónica. Fue desarrollada por un equipo multidisciplinario de expertos y revisada por pares. La guía resume las principales evidencias científicas disponibles sobre la enfermedad renal crónica y ofrece orientación para profesionales de la salud sobre el manejo clínico de esta patología.
El resumen describe los principales cambios en las recomendaciones de 2019 de la Guía de la Asociación Americana de Diabetes sobre el tratamiento y atención de la diabetes. Entre los cambios se incluyen: preferir un agonista del receptor del péptido similar al glucagón en lugar de insulina para pacientes con diabetes tipo 2 que requieren medicamentos inyectables; limitar el beneficio adicional del autocontrol rutinario de glucosa para pacientes con diabetes tipo 2 que no usan insulina; y enfatizar la evaluación del riesgo cardiovascular, la ingesta de agua y
Este documento presenta una guía de práctica clínica sobre la prevención, diagnóstico y tratamiento de la infección por VIH en embarazadas, niños, adolescentes y adultos en Ecuador. La guía fue desarrollada por el Ministerio de Salud Pública a través de un proceso de adaptación de guías internacionales y consenso nacional, con el objetivo de orientar a los profesionales de la salud en la atención clínica de estas poblaciones. La guía incluye recomendaciones actualizadas sobre prevención
Este documento presenta una guía de práctica clínica sobre hipertensión arterial desarrollada por el Ministerio de Salud Pública de Ecuador. La guía define hipertensión arterial, explica su fisiopatología e historia natural, y establece recomendaciones para la prevención, detección, diagnóstico y tratamiento basadas en evidencia científica. La guía busca asistir a profesionales de la salud y pacientes en la toma de decisiones sobre el manejo clínico de la hipertensión.
Esta guía de práctica clínica trata sobre la encefalopatía hipóxica isquémica en recién nacidos y contiene información sobre: 1) la clasificación, diagnóstico diferencial y fisiopatología de esta condición; 2) los aspectos metodológicos considerados en la guía; y 3) las evidencias y recomendaciones para el manejo clínico de los pacientes. La guía fue desarrollada por el Ministerio de Salud Pública del Ecuador y varios hospitales del país con el objetivo de prove
Este documento presenta el protocolo Score MAMÁ y claves obstétricas desarrollado por el Ministerio de Salud Pública de Ecuador. Incluye la herramienta Score MAMÁ para evaluar signos vitales y nivel de conciencia en mujeres embarazadas o puérperas, así como claves de color (roja, azul y amarilla) para la clasificación y manejo de emergencias obstétricas. El objetivo es estandarizar la atención prehospitalaria y de primer nivel para la detección temprana y referencia oportuna de complic
Este documento presenta información sobre la mortalidad materna en Ecuador. Las metas nacionales buscan reducir la razón de mortalidad materna a 40 por cada 100,000 nacidos vivos para el 2017. Se describen las principales causas de muerte materna y se enfatiza la importancia de la planificación familiar y la atención obstétrica de calidad para prevenir estas muertes. Finalmente, se propone la estrategia "Alarma Materna" para mejorar la detección oportuna de complicaciones y la derivación a un nivel de atención adecuado
Este documento presenta el protocolo para el diagnóstico y certificación de la muerte encefálica en Ecuador. Describe los criterios neurológicos para realizar el diagnóstico, incluyendo un examen clínico sistemático y riguroso que confirme la ausencia de reflejos del tronco cerebral y respiración espontánea. También establece la importancia de contar con médicos expertos capacitados para realizar este diagnóstico de gran responsabilidad médico-legal, y la necesidad de disponer de instrumentos normat
Este manual presenta lineamientos para la atención integral de la salud sexual y reproductiva de las personas con discapacidad en Ecuador. Reconoce que históricamente este grupo poblacional ha enfrentado barreras para acceder a estos servicios debido a imaginarios y prácticas que los infantilizan o los consideran asexuados. El documento identifica barreras sociales, culturales, de comunicación, arquitectónicas y de equipamiento, y propone mecanismos para superarlas. También presenta consideraciones generales y lineamientos específicos
Este manual presenta los principios y procedimientos para la gestión de la asistencia humanitaria internacional en situaciones de emergencia y desastre en Ecuador. Detalla las entidades involucradas como la Secretaría de Gestión de Riesgos y el Ministerio de Relaciones Exteriores, y explica los escenarios en los que Ecuador puede participar como país receptor, asistente o facilitador de cooperación internacional. Además, incluye flujogramas y protocolos para coordinar de manera efectiva la ayuda entre los diferentes actores durante una emergencia.
Este documento provee una guía integral para la investigación en salud. Explica los principios básicos y métodos de investigación cualitativa y cuantitativa, y destaca la importancia de los principios éticos en todo el proceso de investigación. Además, brinda referencias actualizadas para aquellos interesados en aprender más sobre los temas cubiertos.
Esta guía de práctica clínica proporciona evidencias y recomendaciones sobre la transfusión de sangre y sus componentes como concentrados de glóbulos rojos, concentrados de plaquetas y plasma fresco congelado. La guía fue desarrollada por un equipo multidisciplinario de expertos en Ecuador con el objetivo de asistir a médicos en la toma de decisiones sobre la transfusión de sangre. La guía incluye definiciones de los componentes de la sangre, recomendaciones para diferentes indicaciones clínicas como cirugía
La Unión Europea ha propuesto un nuevo paquete de sanciones contra Rusia que incluye un embargo al petróleo. El embargo prohibiría la importación de petróleo ruso a la UE y también impediría el acceso de buques rusos a puertos europeos. Sin embargo, Hungría se opone firmemente al embargo al petróleo, argumentando que su economía depende en gran medida de las importaciones de energía rusa.
Esta guía presenta recomendaciones sobre el diagnóstico, manejo y tratamiento de las anomalías de inserción placentaria como la placenta previa, el acretismo placentario y la vasa previa. Proporciona una clasificación de estas condiciones y discute factores de riesgo, manifestaciones clínicas, diagnóstico, manejo prenatal, tratamiento específico y criterios de referencia. El objetivo es asistir a los profesionales de la salud en la toma de decisiones sobre el manejo de estas patologías obstétricas.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- 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
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.