Chorionic villus sampling (CVS) is an invasive prenatal procedure performed between 70-91 days after the last menstrual period to obtain fetal tissue from the chorionic villi of the placenta for genetic testing. CVS yields more cells and DNA than amniocentesis, allowing for rapid chromosomal analysis and biochemical or DNA testing without needing a cell culture. While sometimes considered riskier than amniocentesis, large studies show CVS has a comparable or lower risk of pregnancy loss. CVS can be performed through the abdominal wall or cervix under ultrasound guidance to evaluate the fetus for genetic disorders, chromosomal abnormalities, or metabolic conditions.
presented by HAFIZ M WASEEM
university of education LAHORE Pakistan
i am from mailsi vehari and studied in lahore
bsc in science college multan
msc from lahore
presented by HAFIZ M WASEEM
university of education LAHORE Pakistan
i am from mailsi vehari and studied in lahore
bsc in science college multan
msc from lahore
PGD is a state-of-the-art procedure used in conjunction with In Vitro Fertilization (IVF) in which the embryo is tested for certain conditions prior to being placed in the womb of the woman.
The couples who are planning for a baby, non-invasive pregnancy testing will help you to find out the chances of your baby being born with some common chromosomal conditions.
PGD is a state-of-the-art procedure used in conjunction with In Vitro Fertilization (IVF) in which the embryo is tested for certain conditions prior to being placed in the womb of the woman.
The couples who are planning for a baby, non-invasive pregnancy testing will help you to find out the chances of your baby being born with some common chromosomal conditions.
Interesting Update on Recurrent Miscarriage for Indian Gynaecologoists D...Lifecare Centre
OUTLINE….of RM
* KNOWN KNOWNWhat we know & we DO: **KNOWN UNKNOWNWhat we know but do not do: ***UNKNOWN KNOWNWhat we know that we do not know ****UNKNOWN UNKNOWNTOTALLY NEW .. Future
PCOD,How are they different ??Difficulties & Solutions made Easy , Dr. Sharda...Lifecare Centre
Tremendous advances and extensive human studies have uncovered the complexity and management of PCOD
Global prevalence -2.2% to 26% Roughly 1 in 15 women worldwide, (Lancet, 2007)
THIS PRESENATATION IS FOR THE MEDICAL STUDENTS WHO ALSO HAVE GENETICS AND IF THEY NEED TO GIVE A SEMINAR BASED ON THIS TOPIC THIS PRESENATATION SHALL PROVE USEFUL
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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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.
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
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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
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. Definition
Chorion Biopsy or more popularly known as Chorionic
villus sampling (CVS): an invasive procedure
performed for first-trimester prenatal diagnosis.
CVS is typically performed between 70 and 91 days
after the LMP. In the procedure, tissue is withdrawn
from the villi (vascular fingers) of the chorion, a part
of the placenta, and examined.
3. Embryology of Chorion
FrondosumBefore 9 weeks, chorionic villi cover the
entire outer surface of the gestational sac.
As growth continues, the developing sac
begins to fill the uterine cavity, and most
villi regress except at the implantation site,
where they are associated with the
decidua basalis . Villi in this area rapidly
proliferate to form the chorion frondosum
Between 9 and 12 weeks of gestation, the
villi float freely within the blood of the
intervillus space and are only loosely
anchored to the underlying decidua
basalis.
4. Chorionic villi are fetal in origin,
Appropriate and useful source of tissue for the
evaluation of fetal genetic disease.
Their cytogenetic, molecular, and biochemical properties
reflect those of the fetus.
The villi are partly composed of cytotrophoblast cells,
which are an actively dividing source of spontaneous
mitoses that can be used to obtain a rapid chromosomal
analysis
5. Advantages of CVS?
Yield of cells and DNA from CVS is much greater
than 20ml of amniotic fluid
With shift towards first trimester screen
procedure of choice
Biochemical or DNA analysis can usually be carried
out directly on villi obviating the need and delay of a
cell culture as required after amniocentesis.
6. Indications
CVS can be done for all indications of AC
Cytogenetic: Karyotype/ Single gene disorders
Metabolic: in born errors of metabolism
Molecular: hemoglobinopathies, hemophilia,
7. Indications
Previous child with nondisjunctional chromosome
abnormality
Parent is carrier of balanced translocation or other
chromosome disorder
Both parents are carriers of autosomal recessive disease
Women who are carriers of a X-linked disease
Positive first-trimester screen for trisomy 21 or 18
8. Myth!!!!!
CVS is technically more difficult and riskier as
compared to amniocentesis!!!
Cochrane review (2003)
Total pregnancy loss after TA-CVS is comparable to 2nd trimester
amnio (OR 0.9; 95% CI 0.66-1.23). Higher with TC-CVS ( OR 1.4)
Danish national registry, cohort of over 65,000
miscarriage rates < 24 weeks for amnio vs CVS (1,4 vs 1.9%), overall
0.5-1%
Mujezinovic and Alfirevic, 2007
CVS:Within 2weeks 0.7%, < 24 weeks, 1.3%, Total 2%
Amnio 0.6 % fetal loss within 2wks, 0.9% <24wk, 1.9% total
9. Sampling Technique
Trans Abdominal
Trans Cervical
Though both are equally safe and either can be done in
almost 95-97 %, trans abdominal is a preferred method
and is done by most of the centres
10. Pre procedure
Ultrasound : placental site, number of fetuses,
viability, congenital abnormality, access path
Maternal ABO & Rh grp, Hb
Informed, written consent
11. Trans Abdominal CVS-
Technique
Maternal Abdomen is painted and draped
Gauge 18-20 disposable spinal needle of adequate length (7.5-15mm)
used
The needle passed through anterior abdominal wall into the substance of
the chorion frondosum under continuous ultrasound guidance by freehand
/ needle guide technique.
The stylet is withdrawn and 20ml syringe attached.
Gentle up & down movements with continuous negative pressure are
made taking care to avoid puncturing fetal aspect of amniotic membrane by
U/S control with continuous needle tip visualization.
13. The tissue is then transferred to the culture
medium containing tubes or petri dish and
examined for adequacy of CV before the needle is
withdrawn.
The chorionic villi appear as free-floating,
white structures with fluffy, filiforme branches.
Contaminating decidua tissue has a more
amorphous appearance and lacks distinct branches
14. Transcervical CVS-
Technique
1.5mm cannula made of plastic with metal obturator
Distal 3-5 cm obturator slightly curved
Under aseptic conditions, cannula passed through Cx till internal
OS reached (cervix usually held with tenaculum)
Cannuala tip visualized under U/S guidance is advanced & guided
into the substance of chorion frondosum
Cannula placed parallel to axis of developing placenta & advanced
almost to distal end
15.
16. Post Procedure Care
Antibiotics
To expect mild spotting for 3-5 days.
To expect slight pain for 1-2 days.
Restricted activity 1-2 days.
Abstinence - 2 weeks
Follow up ultrasound after 2 weeks
21. To Conclude
1. Chorionic villus sampling has a low complication rate
comparable to mid-trimester amniocentesis in
experienced hands.
2. CVS is the preferable method of fetal aneuploidy
testing in the first trimester
The aim of Prenatal diagnosis employing any technique
is not to generate perfect babies, But it is to let parents
know about the health of their unborn child to help
them make informed decisions in context of their value
system
22. Thank You!
There are no perfect human
specimens, we are all genetically
flawed – Francis Collins