The document provides information on medical disorders that can affect the nervous system and liver during pregnancy. It discusses changes to the brain and liver during normal pregnancy. It then covers various conditions including strokes, seizures, cerebral vein thrombosis, and postpartum cerebral angiopathy that can impact the nervous system. It also discusses pre-existing liver diseases and conditions like hepatitis that can develop during pregnancy. Treatment approaches for different neurological and liver conditions in pregnancy are outlined.
A comprehensive overview of hypertensive disorders in pregnancy with its complications and management. Mainly focused on gestational hypertension, preeclampsia and eclampsia.
A comprehensive overview of hypertensive disorders in pregnancy with its complications and management. Mainly focused on gestational hypertension, preeclampsia and eclampsia.
The liver is the largest organ in the body
It is located below the diaphragm in the right upper quadrant of the abdominal cavity and extended approximately from the right 5th rib to the lower border of the rib cage.
Peripartum Cardiomyopathy .BOARD scheme for the therapy of patients with acut...magdy elmasry
Definition of peripartum cardiomyopathy;Risk factors for the development of PPCM .Environmental Factors
Vasculohormonal (pregnancy).Genetic Factors Titin-truncating
Variants (TTNtv) .Secretion of prolactin by the anterior pituitary gland, upregulation of endothelial microRNA-146a (miRNA-146a), and placental secretion of soluble fms-like tyrosine kinase receptor 1 (sFlt-1) lead to endothelial dysfunction and cardiomyocyte death.Antisense therapy against microRNA-146a
Prolactin inhibition.bromocriptine .biomarkers in peripartum cardiomyopathy
EMGuideWire's Radiology Reading Room: Peripartum CardiomyopathySean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Peripartum Cardiomyopathy and is brought to you by Kaley El-Arab, MD, Blaire Langa, NP, Claire Lawson, NP, and Ashley Moore Gibbs, DNP. It is has the special guest editors: Richard Musialowski, MD and Laszlo Littmann, MD.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
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Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
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Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
BÀI TẬP BỔ TRỢ TIẾNG ANH GLOBAL SUCCESS LỚP 3 - CẢ NĂM (CÓ FILE NGHE VÀ ĐÁP Á...
CNS and Liver in Pregnancy
1. CME ON MEDICAL DISORDERS IN PREGNANCY NERVOUS SYSTEM AND LIVER Prof. Dr. S Sundar’s Unit Dr. Deepu Sebin, PG in Internal Medicine
2. CNS in Pregnancy Liver Challenges us with the diagnosis Challenges are both in diagnosis and treatment Brain and Liver – There are changes with pregnancy , but not much ! Liver in Pregnancy CVAs and Seizures Pregnancy specific liver diseases
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9. 1. Bushnell CD, Jamison M, James AH. Migraines during pregnancy linked to stroke and vascular diseases: US population based case-control study. BMJ 2009;338:b664.
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17. Stroke and Pregnancy: Postpartum Cerebral Angiopathy 1. Singhal AB, Kimberly WT, Schaefer PW, Hedley-Whyte ET. Case 8-2009: A 36-year-old woman with headache, hypertension and seizure 2 weeks post partum N Engl J Med 2009;360:1126-37.
25. Does She even Need AED ? Polytherapy to Monotherapy Therapy Taper to Lowest Possible Dose Replace Valproate Add Folate 4 mg, Vitamin K in third trimester Adequate Sleep Plan conception after 6 months Use barrier contraception
27. Does She even Need AED ? Polytherapy to Monotherapy Therapy Taper to Lowest Possible Dose, Replace Valproate Add Folate 4 mg. Vitamin K in 3 rd trimester Adquate Sleep Plan conception after 6 months Use barrier contraception Beware of Possble dilution Consider plams drug level monitoring if possible
28. 3.A patient with a seizure in pregnancy or delivery or postpartum Emergency
29. Consider Masulf IF: >20 wks of pregnancy or postpartum Seizure not controlled with IV AED & Sedation Any Features of Preeclampsia in current or previous pregnancy ? No Yes * The initial diagnosis of preeclampsia may be postpartum Suspect CVA/CVT/CNS infection Manage as similar to non pregnant seizure Magnesium Sulphate Diazepam Lorazepam if not resolving
34. Normal Pregnancy Viral Hepatitis H. Gravidarum IHCP HEELP AFLP S .Bilurubin Slightly down AST Normal ALT Normal ALP 3x in 3 rd timester GGT Normal S. Bile Acid Normal PT, INR Normal S.Ammonia Normal Total Count Normal Platelets Normal RBS Normal S.Creatine Normal LDH Normal DIC No
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42. Normal Pregnancy Viral Hepatitis H. Gravidarum IHCP HEELP AFLP S .Bilurubin Slightly down < or >5 AST Normal >1000 ALT Noraml >1000 ALP 3x in 3 rd timester Raised in choleststic ph S. Bile Acid Normal Nl or raised PT, INR Normal Normal S.Ammonia Normal Normal Total Count Normal Normal Platelets Normal Normal RBS Normal Normal S.Creatine Normal Normal LDH Normal Normal DIC No No
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45. Normal Pregnancy Viral Hepatitis H. Gravidarum IHCP HEELP AFLP S .Bilurubin Slightly down < or >5 <5 AST Normal >1000 <500 ALT Noraml >1000 <500 ALP 3x in 3 rd timester Raised in choleststic ph Normal S. Bile Acid Normal Nl or raised Normal PT, INR Normal Normal Normal S.Ammonia Normal Normal Normal Total Count Normal Normal Normal Platelets Normal Normal Normal RBS Normal Normal Normal S.Creatine Normal Normal Normal LDH Normal Normal Normal DIC No No No
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52. Normal Pregnancy Viral Hepatitis H. Gravidarum IHCP HEELP AFLP S .Bilurubin Slightly down < or >5 <5 <5 , direct AST Normal >1000 <500 <300 ALT Noraml >1000 <500 <300 ALP 3x in 3 rd timester Raised in choleststic ph Normal Elevated S. Bile Acid Normal Nl or raised Normal Raised PT, INR Normal Normal Normal Can be elevate S.Ammonia Normal Normal Normal Normal Total Count Normal Normal Normal Normal Platelets Normal Normal Normal Normal RBS Normal Normal Normal Normal S.Creatine Normal Normal Normal Normal LDH Normal Normal Normal Normal DIC No No No No
60. Normal Pregnancy Viral Hepatitis H. Gravidarum IHCP HEELP AFLP S .Bilurubin Slightly down < or >5 <5 <5 , direct <5 AST Normal >1000 <500 <300 >500 ALT Noraml >1000 <500 <300 >500 ALP 3x in 3 rd timester Raised in choleststic ph Normal Elevated Normal S. Bile Acid Normal Nl or raised Normal Raised Normal PT, INR Normal Normal Normal Can be elevate May be elevat S.Ammonia Normal Normal Normal Normal Normal Total Count Normal Normal Normal Normal Normal Platelets Normal Normal Normal Normal Low RBS Normal Normal Normal Normal Normal S.Creatine Normal Normal Normal Normal Usually Nl LDH Normal Normal Normal Normal Raised DIC No No No No Can Occur
75. Normal Pregnancy Viral Hepatitis H. Gravidarum IHCP HEELP AFLP S .Bilurubin Slightly down < or >5 <5 <5 , direct <5 <5 AST Normal >1000 <500 <300 >500 <500 ALT Noraml >1000 <500 <300 >500 <500 ALP 3x in 3 rd timester Raised in choleststic ph Normal Elevated Normal Normal S. Bile Acid Normal Nl or raised Normal Raised Normal Normal PT, INR Normal Normal Normal Can be elevate May be elevat Elevated S.Ammonia Normal Normal Normal Normal Normal Elevated Total Count Normal Normal Normal Normal Normal High Platelets Normal Normal Normal Normal Low Low RBS Normal Normal Normal Normal Normal Low S.Creatine Normal Normal Normal Normal Usually Nl Can be raised LDH Normal Normal Normal Normal Raised Raised or normal DIC No No No No Can Occur Yes
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Editor's Notes
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Folic acid supplementation — Low serum folate levels in women with epilepsy are independently associated with an increased risk of major fetal malformations [3] . It has not yet been conclusively determined if folic acid supplementation prevents neural tube defects in women receiving AEDs. However, animal studies have shown that valproate and phenytoin decrease the concentration of certain forms of folate and are associated with neural tube defects [4,5] .
Pregnancy is accompanied by many alterations in drug metabolism, including increased liver metabolism, renal clearance, and volume of distribution, and decreased gastrointestinal absorption and plasma protein binding [15,23,24] . As an example, for AEDs that are highly protein bound (eg, phenytoin, valproate), the total plasma drug level may decrease with impaired protein binding, but the physiologically important free or unbound drug concentration may not change. As a result, free drug levels for these AEDs may be more reliable during pregnancy. However, medication dosage should be adjusted if the patient's seizures are not controlled, not because the free or total level has decreased.
immunisation
The origin of the liver disease associated with hyperemesis gravidarum is unclear. Not all affected patients have liver disease; therefore, the vomiting does not appear to be secondary to the liver involvement. Starvation alone does not seem to be an adequate explanation for the liver dysfunction, particularly in as much as biopsy in affected patients fails to show the fatty infiltration typical of starvation .
pedaitrician
Low haptoglobin – most sensitive measure for hemolysis. Seen before plt count drops.
Maternal complication seen in 12-65% of cases
50% mortality due to hepatic hematoma with rupture
