This document discusses decreased fetal movements. It begins by describing normal fetal movements and when they are first felt by the mother. It then discusses how a significant reduction in movements is a clinical sign and presents two common methods to record fetal kicks. It provides guidance on when a woman should contact her doctor if concerned about a reduction in movements. The document discusses investigations that should be performed if reduced fetal movements are reported, including using Doppler and ultrasound to assess the fetus. It provides guidance on the optimal management of reduced fetal movements at different gestational ages.
A biophysical profile is a prenatal test which is used to check on a baby's well-being. The test combines the fetal heart rate monitoring (NST- Non Stress Test) and fetal ultrasound to evaluate a Fetal heart rate, movements, breathing, muscle tone and amniotic fluid level.
Prelabour Rupture of Membrane (PROM) by Sunil Kumar Dahasunil kumar daha
Please find the power point on Prelabour Rupture of Membrane (PROM). I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Meconium-stained amniotic fluid is common complication, seen in 1 out of every 5 pregnancies.Golden rule for management of MSAF is Foetal Heart Monitoring
A biophysical profile is a prenatal test which is used to check on a baby's well-being. The test combines the fetal heart rate monitoring (NST- Non Stress Test) and fetal ultrasound to evaluate a Fetal heart rate, movements, breathing, muscle tone and amniotic fluid level.
Prelabour Rupture of Membrane (PROM) by Sunil Kumar Dahasunil kumar daha
Please find the power point on Prelabour Rupture of Membrane (PROM). I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Meconium-stained amniotic fluid is common complication, seen in 1 out of every 5 pregnancies.Golden rule for management of MSAF is Foetal Heart Monitoring
Antenatal assessment physical well being /introduction and methodsBabitha Mathew
The tests used to monitor fetal health include fetal movement counts, the nonstress test, biophysical profile, modified biophysical profile, contraction stress test, and Doppler ultrasound exam of the umbilical artery.
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
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
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This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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
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.
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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2 Case Reports of Gastric Ultrasound
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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2. Fetal movements
Kick
wave
swish (his) or
roll
First felt by the mother between 18-20 w
and rapidly acquire a regular pattern.
an indication of the integrity of the central nervous
system and musculoskeletal systems.
Aboubakr Elnashar
3. Women perceive
most movement when lying down,
fewer when sitting and
least while standing.
Busy pregnant women for example who are not
concentrating on fetal activity often report a
misperception of RFM.
Aboubakr Elnashar
4. A significant reduction or sudden change in
movement is an important clinical sign.
Mothers may feel anxious if there is a decrease in
fetal movement however there are often reasonable
reasons for this.
The fetus may be in a state of sleep or the mother
may be too busy to focus on fetal activity.
Aboubakr Elnashar
5. Two common ways to record fetal kicks.
1. Cardiff Count to Ten Method.
This is an 8 to 12 hour period that records at least
ten of baby’s movement.
Aboubakr Elnashar
6. 2. One to Two Hours Method.
This is done while lying down on your left side for 30
minutes after eating without distractions. After an
evening meal might be ideal time to record. Baby
should move 10 times within an hour to 75 minutes.
Aboubakr Elnashar
8. although fetal movements tend to plateau at 32
w, there is no reduction in the frequency of fetal
movements in the late third trimester.
Aboubakr Elnashar
9. Should fetal movements be counted routinely in a
formal manner?
There is insufficient evidence to recommend
formal fetal movement counting using specified
alarm limits.
Women should be advised to be aware of their
baby’s individual pattern of movements.
If they are concerned about a reduction in or
cessation of fetal movements after 28+0weeks of
gestation, they should contact their doctor.
and should not wait until the next day for
assessment of fetal wellbeing.
Aboubakr Elnashar
10. After 28 w if a woman is unsure whether
movements are reduced she is advised to lie on her
left side and focus on fetal movement for 2 hours.
If she does not feel 10 or more discrete movements
then she should contact her doctor immediately.
If a clinician is presented with a woman reporting
RFM, a relevant history should be taken to assess the
woman’s risk factors for stillbirth and FGR
Aboubakr Elnashar
11. a handheld Doppler device can be used to confirm
the presence of the fetal heart beat.
If the presence of a fetal beat is not confirmed then
immediate ultrasound scan is needed to assess fetal
cardiac activity.
CTG monitoring
should be used if the pregnancy is over 28 w and
there is still RFM after fetal viability has been
confirmed.
for at least 20 minutes
Aboubakr Elnashar
12. Ultrasound scanning
can also be used as part of the preliminary
investigations of a woman reporting RFM if the
perception of RFM persists despite a normal CTG.
Aboubakr Elnashar
13. Women should be reassured that 70%of
pregnancies with a single episode of RFM are
uncomplicated.
There are no data to support formal fetal
movement counting (kick charts) after women have
perceived RFM in those who have normal
investigations.
Women who have normal investigations after one
presentation with RFM should be advised to contact
doctor if they have another episode of RFM.
Aboubakr Elnashar
14. Women who report RFM on two or more
occasions are at an increased risk of a poorer
perinatal outcome including an increased risk of
stillbirth, fetal growth restriction and/or preterm
birth.
Aboubakr Elnashar
15. What is the optimal management of RFM before
24+0 weeks of gestation?
Presence of a fetal heartbeat should be confirmed
by auscultation with a Doppler handheld device.
If fetal movements have never been felt by 24
weeks of gestation, referral to a specialist fetal
medicine centre should be considered to look for
evidence of fetal neuromuscular conditions
Aboubakr Elnashar
16. What is the optimal management of RFM between
24+0 and 28+0 weeks of gestation?
Presence of a fetal heartbeat should be confirmed
by auscultation with a Doppler handheld device.
Aboubakr Elnashar
17. RCOG, 20011
1. History
Risk factors for stillbirth and FGR.
Sudden change in fetal activity
2. Auscultate the fetal heart
Doppler device to exclude fetal death.
3. CTG
{exclude fetal compromise}
Aboubakr Elnashar
18. 4. US
RFM persists despite a normal CTG
risk factors for FGR/stillbirth.
AC
EFW {detect the SGA}
AFV
Fetal morphology
Doppler
Aboubakr Elnashar
19. US/2w: HC and AC.
AC
most sensitive predictor of fetal growth.
increases 2cm/2w after 24 w in the average fetus.
measurements are plotted on centile charts.
fall in the growth velocity of AC indicates IUGR.
AC used to assess fetal growth
Aboubakr Elnashar
21. Doppler
more useful test of fetal wellbeing than CTG or FBP.
Umbilical arterial blood flow becomes abnormal when
there is placental insufficiency.
Middle cerebral artery
Aboubakr Elnashar
22. a. Umbilical artery Doppler
Idea:
Umbilical Arterial Flow is normally low resistance.
In hypoxic states:
relative placental hypoxia:
reactive VC of umbilical artery tributaries:
higher resistance:
relative decrease in diastolic flow detectable by
Doppler.
Aboubakr Elnashar
24. •Resistance index:
Best ability to predict abnormal outcomes
(RCOG,2002 Evidence level II)
Normal pregnancy:
{progressive increase in end-diastolic velocity
{growth& dilatation of the umbilical circulation}:
Resistance index falls.
Fetal growth restriction and/or PET:
> 0.72 is outside the normal limits from 26 w.
Aboubakr Elnashar
25. •S/D should be <3.
small increases in S/D= 3-5: chronic intrauterine
disease manifest by IUGR.
Not strictly useful:
{1. low sensitivity.
2. Gestation age dependent}.
•Diastolic flow is absent or reversed:
Fetal distress is almost certain:
Delivery may be indicated.
Aboubakr Elnashar
27. 5. ± BPP:
± a role in high risk pregnancies:
Systematic review of RCT:
does not support its use as a test of fetal wellbeing
Uncontrolled observational studies:
BBP has good NPV
Fetal death is rare with normal BPP.
Aboubakr Elnashar