Dr. Shantanu discusses the challenges of operative obstetrics in rural areas. Rural practice requires one to take on many roles from doctor to electrician. Resources are limited with poor support, no health insurance, and tight budgets. Blood supply can be challenging to obtain, requiring innovative solutions like autologous blood donation. Constant vigilance and preparedness are needed to manage obstetric emergencies like postpartum hemorrhage without adequate blood supply on hand. Well-trained staff, proper equipment, and rehearsed drills are vital for responding quickly in emergency situations.
Dental Website Design http://medicalmarketingnow.com
To get more leads from your dentist website design for your practice then have to know the important dental web design factors. There are lots of different dentist websites out there but there are similarities between the most effective websites. If local consumers find your website on the internet then your website will be their first impression of your practice… make sure it’s a good one! IF you want to have the best dental website design then simply follow our video training.
This is Dentist Marketing Now and we help dentist improve their marketing strategy and get new leads. Since we focus specifically on dental marketing we know the ins and outs of the industry and how to develop dominating marketing strategies. Our YouTube channel offers free training videos on a plethora of dentist marketing and dental advertising topics. Please be sure to comment like and subscribe for more free training
Dental Website Design http://medicalmarketingnow.com
To get more leads from your dentist website design for your practice then have to know the important dental web design factors. There are lots of different dentist websites out there but there are similarities between the most effective websites. If local consumers find your website on the internet then your website will be their first impression of your practice… make sure it’s a good one! IF you want to have the best dental website design then simply follow our video training.
This is Dentist Marketing Now and we help dentist improve their marketing strategy and get new leads. Since we focus specifically on dental marketing we know the ins and outs of the industry and how to develop dominating marketing strategies. Our YouTube channel offers free training videos on a plethora of dentist marketing and dental advertising topics. Please be sure to comment like and subscribe for more free training
Yaks, Cows, Dogs and Cats: The Nepal Paradoxes of Religiosity, Poverty and th...sharon methvin
Yaks, Cows, Dogs and Cats: The Nepal Paradoxes of Religiosity, Poverty and the Economy of Animals. Sharon recently returned from spending a year in Asia, six months of which were spent living at her teacher’s monastery in Nepal and traveling in the Himalayas. During that time, she witnessed the paradoxical conditions for animals in a country that is immersed in Hinduism and Buddhism. After witnessing the daily lives of food, transport and pet animals, she became involved with several animal advocacy organizations in Kathmandu. In this presentation, Sharon will explain some of the complex paradoxical conditions for animals in Nepal and share photos and stories from her experiences with the animals and the courageous people helping them. During that time, she witnessed the paradoxical conditions for animals in a country that is immersed in Hinduism and Buddhism. After witnessing the daily lives of food, transport and pet animals, she became involved with several animal advocacy organizations in Kathmandu. In this presentation, Sharon will explain some of the complex paradoxical conditions for animals in Nepal and share photos and stories from her experiences with the animals and the courageous people helping them. Animals, Buddhism, Hinduism, Poverty, Animal Welfare, Meat Eating, Vegetarianism, Nepal. Sharon recently returned from spending a year in Asia, six months of which were spent living at her teacher’s monastery in Nepal and traveling in the Himalayas. During that time, she witnessed the paradoxical conditions for animals in a country that is immersed in Hinduism and Buddhism. After witnessing the daily lives of food, transport and pet animals, she became involved with several animal advocacy organizations in Kathmandu. In this presentation, Sharon will explain some of the complex paradoxical conditions for animals in Nepal and share photos and stories from her experiences with the animals and the courageous people helping them.
ATLS is two days course for those who manage trauma patients. These protocols have been followed by hospitals all over the world to treat trauma patients quickly and efficiently.
Clinical pelvimetry and Forceps Assisted Vaginal DeliveryArthur Greenwood
A review of clinical pelvimetry and its usefulness in determining if a operative vaginally delivery may be performed. Multiple types of forceps are reviewed. This is a must read for all obstetric providers.
Yaks, Cows, Dogs and Cats: The Nepal Paradoxes of Religiosity, Poverty and th...sharon methvin
Yaks, Cows, Dogs and Cats: The Nepal Paradoxes of Religiosity, Poverty and the Economy of Animals. Sharon recently returned from spending a year in Asia, six months of which were spent living at her teacher’s monastery in Nepal and traveling in the Himalayas. During that time, she witnessed the paradoxical conditions for animals in a country that is immersed in Hinduism and Buddhism. After witnessing the daily lives of food, transport and pet animals, she became involved with several animal advocacy organizations in Kathmandu. In this presentation, Sharon will explain some of the complex paradoxical conditions for animals in Nepal and share photos and stories from her experiences with the animals and the courageous people helping them. During that time, she witnessed the paradoxical conditions for animals in a country that is immersed in Hinduism and Buddhism. After witnessing the daily lives of food, transport and pet animals, she became involved with several animal advocacy organizations in Kathmandu. In this presentation, Sharon will explain some of the complex paradoxical conditions for animals in Nepal and share photos and stories from her experiences with the animals and the courageous people helping them. Animals, Buddhism, Hinduism, Poverty, Animal Welfare, Meat Eating, Vegetarianism, Nepal. Sharon recently returned from spending a year in Asia, six months of which were spent living at her teacher’s monastery in Nepal and traveling in the Himalayas. During that time, she witnessed the paradoxical conditions for animals in a country that is immersed in Hinduism and Buddhism. After witnessing the daily lives of food, transport and pet animals, she became involved with several animal advocacy organizations in Kathmandu. In this presentation, Sharon will explain some of the complex paradoxical conditions for animals in Nepal and share photos and stories from her experiences with the animals and the courageous people helping them.
ATLS is two days course for those who manage trauma patients. These protocols have been followed by hospitals all over the world to treat trauma patients quickly and efficiently.
Clinical pelvimetry and Forceps Assisted Vaginal DeliveryArthur Greenwood
A review of clinical pelvimetry and its usefulness in determining if a operative vaginally delivery may be performed. Multiple types of forceps are reviewed. This is a must read for all obstetric providers.
Similar to Challenges in operative obstetrics in rural areas (20)
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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
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.
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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.
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
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3. DR.SHANTANU
Rural practice is a subspeciality
in itself…
• Low cost high risk practice.
• One wo/man show.
• You are forced to be alert, to be
innovative, to be an electrician, a plumber,
a nurse and a doctor all rolled into one
• Diploma in rural medical practice
• Dip. M.P.R.P.S.
4. DR.SHANTANU
Tight rope walk
• Poor paramedical support
• No health insurance
• Shoestring budgets and packages
• Monsoon economy
–Farmer suicides
6. Where the mind is without fear: and the head is held high,
Where blood is free,
Where blood comes from voluntary healthy donors,
Where blood has been broken up into fragments by the refrigerated centrifuge,
Where the clear stream of blood and blood products from the RBTC has found its
way to the remotest storage centers,
Where tireless updating, CMEs & net surfing stretches its arms towards
perfection,
Where blood banking is led forward by thee into ever widening network and action,
Into that heaven of rural blood banking my father let my country awake.
10. HIGH RISK…IF
• DISTANCE FROM THE
NEAREST BLOOD BANK,
• NEAREST COLLEAGUE
• NEAREST REFERRAL
UNIT
IS MORE THAN AN
HOUR , IN TERMS OF
DURATION OF TRAVEL
EVERY CASE IS HIGH
RISK
12. Always on alert
• Hb for all
• and coagulation screen for all high risk cases
• BT CT PC PT ARE LATE MARKERS
• APTT TT FDP NOT AVAILABLE
• ICTERUS MEANS DOOM
• IF A CLOT FORMS AND DISSOLVES IT
SPELLS DOOM
• RESPONSIBLE RELATIVE
16. Always on alert
• Active management of (all) stages of labor
• Consider Misoprostole P/R
– No magic pill this
– Takes 20 min
– Not very useful for massive loss
17. Always on alert
• Well equipped and well trained staff in the
labor room
• PPH box/equipment tray
• PPH display charts
• PPH drills
18. पी.पी.एच. झाले मारा बोंब ;
हाय ररस्कची करा नोंद.
II मातृ देवो भव IIगुरुवार, 18 जून
2015
19
19. दया हेड लो , दया ललथो टॉमी
II मातृ देवो भव IIगुरुवार, 18 जून
2015
20
20. कॅ थेटर घाला ब्लॅडरमधी
II मातृ देवो भव IIगुरुवार, 18 जून
2015
21
21. सोळा नंबर इंट्राकॅ थ ,
दोन्ही हातांना लावा स्टेट
II मातृ देवो भव IIगुरुवार, 18 जून
2015
22
22. घ्या भरपूर ब्लड सॅम्पल
II मातृ देवो भव IIगुरुवार, 18 जून
2015
23
23. मगच सुरु करा ररंगरचा नळ
II मातृ देवो भव IIगुरुवार, 18 जून
2015
24
24. मसाज करा , क्लॉट काढा,
टाके घाला झटपट
II मातृ देवो भव IIगुरुवार, 18 जून
2015
25
25. मसाज करा , क्लॉट काढा,
टाके घाला झटपट
II मातृ देवो भव IIगुरुवार, 18 जून
2015
26
26. मसाज करा , क्लॉट काढा,
टाके घाला झटपट
II मातृ देवो भव IIगुरुवार, 18 जून
2015
27
27. रक्त साकळतंय का बघा ,
नाहीतर येईल आफत.
II मातृ देवो भव IIगुरुवार, 18 जून
2015
28
37. Always on alert
• Well equipped and well staffed labor room
• PPH box/equipment tray
• PPH display charts
• PPH drills
38. WHEN IT HAPPENS…
• ASSISTANTS AND COLLEAGUES MUST BE
TUNED TO THE SITUATION
– LABOUR WARD DRILLS
• RAISE AN ALARM 1
• LARGE BORE I/V ACCESS + BLOOD SAMPLES +2
• MASSAGE / UTEROTONICS (MDR) +1
• O2 BY MASK +1
• CATHETER
• HEADLOW
• EXAMINATION
39. PRE –OP PREPARATION
• PLAN YOUR INCISION
– ABDOMINAL
• MIDLINE VERTICAL FOR A CLASSICAL
OPERATION
• CONSIDER PREVIOUS SCARS
– UTERINE
• PLACENTAL POSITION
• VASCULARITY
40. PRE –OP PREPARATION
• BLOOD & BLOOD PRODUCTS
• AUTOLOGUS TRANSFUSION
– r Hu EPO IS NOW AVAILABLE
– IATROGENIC POLYCYTHEMIA IS
POSSIBLE
41. PRE –OP PREPARATION
• MATURITY CHECK
– MORE IMPORTANT IF COMPLICATIONS
HAVE SET IN LIKE GEST DM, PIH, IUGR
– EARLY USG
– L/S RATIO …. AMNIO…CHECK L BODIES
– BUBBLE STABILITY TEST
– PRE-TREATMENT WITH STEROIDS AND
MgSO4
42. WHEN IT HAPPENS…
• BACK UP POWER SUPPLY
• BACK UP SUCTION MACHINE
• HAVE STIRRUPS AVAILABLE SO THAT
FROG LEG POSITION (MIND YOU, NOT
LITHOTOMY) IS POSSIBLE
43. INTRA–OP
• INCISION
– EXCESSIVE BLEEDING IS NOTED RIGHT
FROM THE CUTANEOUS INCISION
– USE CAUTERY
– USE A STAY SUTURE ON THE LOWER
EDGE
45. INTRA–OP
• AORTIC PRESSURE
• EXTERIORISE THE UTERUS
• PACK TIGHT WITH ALL YOUR MIGHT
WITH A HOT MOP
• FOUR VESSEL LIGATION
• CHECK
• SOS IIL
• SOS HYSTERECTOMY
49. INTRA–OP
• B-LYNCH SUTURE
• HAYMAN SUTURE
– VERTICAL AND
HORIZONTAL
CERVICO-ISTHUMIC
SUTURES
• CHO MULTIPLE
SQUARE SUTURES
– HAVE DIAGRAMS IN
PPH KITS
50. INTRA–OP
• B-LYNCH SUTURE
• HAYMAN SUTURE
– VERTICAL AND
HORIZONTAL
CERVICO-ISTHUMIC
SUTURES
• CHO MULTIPLE
SQUARE SUTURES
– HAVE DIAGRAMS IN
PPH KITS
51. INTRA–OP
• PLACENTA ACCRETA
– DIAGNOSIS
• PRE OP
• INTRA OP
– Wring the uterine neck and chop off the uterus
• LEAVING PLACENTA IN SITU
– CLOSE MONITORING
52. INTRA–OP
• OBSTETRIC HYSTERECTOMY
– SUBTOTAL MAY NOT SUFFICE
– REMAIN INSIDE THE UTERINES
– CC CC SO TL
– CLAMP-CUT; CLAMP-CUT …. SPECIMEN
OUT… TRANSFIX & LIGATE
54. BATTLING BLOOD LOSS SANS
BLOOD.
• RESTORE AND MAINTAIN ADEQUATE
BLOOD VOLUME.
• WRAP BOTTLES IN BP CUFFS & PUMP
• CRYSTALLOIDS: THRICE THE ESTIMATED
BLOOD LOSS
• COLLOIDS AND STARCH SOLUTIONS ONLY
LATER
55. BATTELING BLOOD LOSS SANS
BLOOD
• OXYGEN, WARM BLANKETS,EVEN
PLASTIC GOWNS AND…
• WARM FLUIDS…USE MICROWAVE,
PUT BOTTLES IN HOT WATER
• HEATLOSS ADDS TO SHOCK AND DIC
56. VENOUS ACSESS
• 14 OR 16 G INTRAVENOUS CANNULA
• FEMORAL VEIN
• SUBCLAVIAN
• INT JUGULAR
– POST APPROACH
– ANT APPROACH
• Keep diagrams on the notice boards
57.
58. VENOUS ACSESS
• 14 OR 16 G INTRAVENOUS CANNULA
• FEMORAL VEIN
• SUBCLAVIAN
• INT JUGULAR
– POST APPROACH
– ANT APPROACH
• Keep diagrams on the notice boards
59.
60. VENOUS ACSESS
• 14 OR 16 G INTRAVENOUS CANNULA
• FEMORAL VEIN
• SUBCLAVIAN
• INT JUGULAR
– POST APPROACH
– ANT APPROACH
• Keep diagrams on the notice boards
61.
62. VENOUS ACSESS
• 14 OR 16 G INTRAVENOUS CANNULA
• FEMORAL VEIN
• SUBCLAVIAN
• INT JUGULAR
– POST APPROACH
– ANT APPROACH
• Keep diagrams on the notice boards
63.
64. BATTELING BLOOD LOSS SANS
BLOOD.
• MAINTAIN SUFFICIENT OXYGEN
CARRYING CAPACITY. KEEP HER
INTUBATED, IF NEED BE, TILL BLOOD
IS AVAILABLE.
• SECURE HEAMOSTASIS. AT TIMES
OPERATING WITHOUT BLOOD IS
SAFER THAN AWAITING BLOOD.
65. SOME PRACTICAL TIPS
• CUT A BOTTLE OF NS AT IT’S BASE & KEEP JUST
100ml OF NS
• ADD 1000iu INJ HEPARIN
• POUR SALVAGED BLOOD THROUGH 6 LAYERED
GAUSE
• MIX WELL
• INFUSE
78. Never change the brands of
injectables, medicines, i/v fluids
etc:
remember you are dealing
with persons wrapped in
white saris and not
‘nurses’
79. A place for everything and
everything in its place
80.
81. RCOG GUIDELINES
• SYMPHISIOTOMY, O’SULLIVAN’S
TECHNIQUE FOR INVERSION OF
UTERUS… FORCEPS / CRANIOTOMY
FOR AFTER COMING HEAD…
GENUPECTORAL POSITION FOR
PROLAPSED CORD… MANUAL
ROTATION FOR POP… ARE FOR
REAL!!!
85. RCOG GUIDELINES
• AN OCCASIONAL UNINDICATED CS
DOEN NOT AN AUDIT MAKE!!!!
• ERR ON THE SIDE OF TOO SOON
RATHER THAN TOO LATE…
86. RCOG GUIDELINES
• THICK MSL… NO ANESTHETIST
• LLP
• ATROPINE
• AMNIOINFUSION
• OXYGEN, SODABICARD OF DOUBTFUL
EFFICACY
87. RCOG GUIDELINES
• BICEPS & TRICEPS ARE AT TIMES
SAFER THAN VACCUM & FORCEPS
• BEREADY TO USE THE MIDPELVIC
APPLICATION
88. RCOG GUIDELINES
• YOU ARE A TIRTIARY LEVEL
PHYSICIAN WORKING AT THE
PRIMARY LEVEL
• YOU NEED TO BE MORE SKILLED
THAN YOUR URBAN COLLEAGUE
• A JACK OF ALL AND A MASTER OF ALL
89.
90.
91.
92.
93.
94. THANK YOU
• DR. VILAS PARAMANE
• DR. VIDYADHAR GHOTAWDEKAR
• DR. VINAY JOGALEKAR
• DR. SHIVDE (LONAND)
• DR. LATA PATIL
• DR. ULKA POL
95. LAMELLAR BODIES INSTEAD
OF L/S RATIO
• There is another factor to consider when addressing the relevance
of FLM testing: due to improvements in gestational age dating,
maternal administration of corticosteroids that accelerate fetal lung
maturity in at-risk pregnancies, and exogenous surfactant
replacement therapies, the number of newborn deaths due to RDS
has continued to decline over the last 15 years. Interestingly, most
laboratories have noted a decline in the number of FLM tests that
they perform each year. This trend reflects the decreased use of the
tests by obstetricians, many of whom indicate that the tests are no
longer needed for patient care.1 When one considers these facts in
light of the Bates study, it becomes legitimate—and provocative—to
ask the question: “Are tests of fetal lung maturity obsolete?”
18 June 2015 MATRU DEWO BHAVA