The document provides guidelines for managing the first stage of normal labor, including objectives like maintaining normalcy and detecting deviations, and principles like noninterference and careful monitoring. It outlines assessments and observations of the mother like vital signs and urine, and of the fetus like heart rate. Guidelines are given for supportive care during labor like positioning, mobility, nutrition, and pain relief.
Preparation for delivery of mother, baby and midwife and equipmentsDR MUKESH SAH
In addition to their delivery bags, midwives “carry” many other invaluable tools ... family planning, delivery preparation, postnatal counseling and breastfeeding. ... With this equipment, we can recover 80% of newborns. ... “Midwifery feels good when both the mother and baby come out of the labor ward alive.
Many women experience some minor disorders during pregnancy.
Every system of the body may be affected during pregnancy. These disorders, however , are not minor to the pregnant woman.
The second stage of labor begins when the cervix is completely dilated (open), and ends with the birth of your baby. Contractions push the baby down the birth canal, and you may feel intense pressure, similar to an urge to have a bowel movement. Your health care provider may ask you to push with each contraction.
Preparation for delivery of mother, baby and midwife and equipmentsDR MUKESH SAH
In addition to their delivery bags, midwives “carry” many other invaluable tools ... family planning, delivery preparation, postnatal counseling and breastfeeding. ... With this equipment, we can recover 80% of newborns. ... “Midwifery feels good when both the mother and baby come out of the labor ward alive.
Many women experience some minor disorders during pregnancy.
Every system of the body may be affected during pregnancy. These disorders, however , are not minor to the pregnant woman.
The second stage of labor begins when the cervix is completely dilated (open), and ends with the birth of your baby. Contractions push the baby down the birth canal, and you may feel intense pressure, similar to an urge to have a bowel movement. Your health care provider may ask you to push with each contraction.
Postnatal care (PNC) for the mother should respond to her special needs, starting within an hour after the delivery of the placenta and extending through the following six weeks. The care includes the prevention, early detection and treatment of complications, and the provision of counselling on breastfeeding, birth spacing, immunization and maternal nutrition. To standardise the PNC service, you are advised to use the screening, counselling and postnatal care cards. These cards ensure that you have covered all the essential steps in every home visit.
this ppt is beneficial for nursing and obstetric and gynaecology students.
First Stage of Labour nsg management.pptxitisha prasad
first stage of labour is the time period from the time of true labour to the full dilation of the cervix. it is most crucial time which requires proper and efficient care and support. Nursing managment during this time is very essential in order to procced with the normal labour. Partograph is one of the biggest tool to asess the progress of labour . It is very important to know the care to be provided during labour to the mothers including the care of bowel, bladder, ambulation, rest, positions, all of this help to keep a track of labour and they assist in the progress of labour.
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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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.
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.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
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
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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
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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
2. OBJECTIVES
• Aims of management of normal labor
• Purposes of management of first stage of labor
• Principles of management of first stage of labor
• Preliminaries
• Management of first stage of labor
3. Aims of management of normal labor
• Maximal observation with minimal active intervention.
• To maintain the normalcy and to detect any deviation from
the normal at the earliest possible moment.
4. MANAGEMENT OF THE FIRST STAGE
• To conduct safe and clean delivery.
• To prevent woman from over exhaustion, injuries, bleeding
and other complications( eg: maternal and fetal distress) and
provide necessary help when required.
Purposes
5. MANAGEMENT OF THE FIRST STAGE
• For maintenance of normal delivery at normal time interval.
• For delivery of healthy, live and normal baby.
• To identify deviation and take corrective measures at the earliest.
Purposes Cont…
6. Principles of first stage management
(1) Noninterference with watchful expectancy so as to prepare the
patient for natural birth.
(2) To monitor carefully the progress of labor, maternal conditions and
fetal behavior so as to detect any intrapartum complication early.
7. PRELIMINARIES
• History taking
• Thorough general and obstetrical examinations including
vaginal examination.
• Record review
• Health teaching
8. Actual management of first stage of labor
• Supportive care
• Positioning and mobility
• Rest and Ambulation
• Nutrition
• Bladder care
• Bowel elimination
care
• Prevention of
infection
• Relief of pain
• Observations
9. Actual management of first stage of labor
• Companion of her choice and, same health care provider
throughout labor and childbirth if possible.
• Ensure good communication and support by staff.
• Ensure privacy and confidentiality
SUPPORTIVE CARE
10. SUPPORTIVE CARE
Cont…
• Advice to avoid dorsal supine
position to avoid aortocaval
compression. (pressure of the
uterus against blood vessels
decreases blood supply and oxygen
to the fetus.)
Positioning and mobility
11. Rest and Ambulation
If membranes intact – walk, sit or to lie down during pains.
• This attitude prevents vena-caval compression and encourage
descent of head.
• Ambulation reduce the duration of labor, need of analgesia and
improve maternal comfort.
If membrane rupture early or when an analgesic drug is given, the
women should be in bed.
12. Nutrition
• An adequate intake of fluids and calories required to met the energy
demand and fluid losses.
• Plain water, salty lemon water, soup, fruit juice is given.
• Intravenous fluid with ringer solution if regional anesthesia or if
unable to take pr oral or dehydrated.
13. Bladder care
• Empty every 1-2 hours during labor.
• Provide bed pan if required.
• Privacy and comfort.
• Catheterisation with strict aseptic precaution.
• Careful record regarding amount and time of voiding should be kept.
14. Bowel elimination care
• Stools formed in the large intestine is moved downward toward the
anorectal area by pressure exerted by the fetal presenting part as it
descends.
• The stool is expelled during second stage pushing.
• Increases the risk of infection, may embarrasses the woman thereby
reducing the effectiveness of these efforts.
15. Prevention of infection
• Visitor should be control
• Personal hygiene- hand
washing.
• Strict aseptic technique.
• Maternal temperature and
vaginal discharge are
assessed frequently (every
1-2 hrs)
16. Relief of pain
• Suggest changes of position.
• Encourage mobility.
• Encourage her companion to massage her back or hold her hand,
sponge her face between contractions and place a cool cloth at the back
of her neck.
17. Relief of pain cont…
• Encourage the woman to use the breathing techniques.
• Encourage the woman to take a warm bath or shower.
• If necessary, offer morphine 0.1 mg/kg body weight IM, informing the
woman of the advantages and disadvantages and obtaining consent.
18. Avoid the following practices
X Do not routinely shave the perineal/pubic area prior to a vaginal
birth.
X Do not routinely cleanse the vagina with an antiseptic (e.g.
chlorhexidine) during labor for the purpose of preventing infectious
morbidities, even in women with documented Group B streptococcus
colonization.
X Do not routinely give an enema to women in labor.
19. OBSERVATIONS
1) Vital signs
During the latent phase of the first stage of labour
• Check maternal mood and behaviour (distressed, anxious) at least
once every hour;
• Check blood pressure, pulse and temperature at least once every four
hours.
ASSESSMENT OF MATERNAL CONDITION
20. ASSESSMENT OF MATERNAL CONDITION
During the active phase of first stage of labor
• Maternal mood and behavior (distressed, anxious) at least
once every 30 minutes;
• Blood pressure at least once every four hours.
Temperature at least once every two hours and
Pulse once every 30 minutes.
21. Alert if
• Pulse rate>100 b.p.m: anxiety, pain and infection, ketoacidosis and
hemorrhage.
• Temperature >38°C- infection, dehydration (at least every two
hours.)
• Supine position, shock, epidural anesthesia, suspect occult or frank
haemorrhage: hypotension.
22. Alert if cont…
• Pre-eclampsia: hypertension during pregnancy.
• Rate over 20 respirations/min: severe anxiety or other
pathologies.
23. 2. Urinalysis
• May be tested for glucose, ketones and proteins.
• Ketones may occur as a result of starvation, dehydration or maternal
distress when all available energy has been utilized. (Give dextrose
IV.)
• Trace of protein: rupture of membrane/urinary infection.
24. 3. Fluid analysis
4. Abdominal examination and contractions
• Is carried out when midwife first examines the mother.
• Should be repeated at intervals throughout labor in order to assess the
length, strength and frequency of contraction and descent of
prescribing part.
25. ASSESSMENT OF FETAL CONDITION
Fetal heart rate: 110 to 160 per minute.
• During the latent phase: full minute count at least once every hour.
• During the active phase : every 30 minutes
• During second stage : every five minutes.
Note: If there are fetal heart rate abnormalities (less than 100 or more
than 180 beats per minute), suspect fetal distress.
(IMPAC revised edition)
26. Reassess the fetal heart rate after
• Rupture of membranes
• Vaginal examination
• Ambulation (before and after)
• Change in infusion rate of
oxytocin administration of
drugs (before and after)
• Urinary catheterization
• Expulsion of the fetus
• Recognition of abnormal
uterine activity
• Decrease in fetal activity as
felt by the mother
27. Status of the membrane
• Note the color of the draining amniotic fluid.
• Presence of thick meconium - need for close monitoring and possible
intervention for management of fetal distress such as keeping women
in prop-up position and stop the oxytocin drip.
• Absence of fluid draining after rupture of the membranes is an
indication of reduced volume of amniotic fluid, which may be
associated with fetal distress.
A distended bladder may impose descent of presenting part, inhibit uterine contractions and leads to decrease bladder tone or atony of the uterus after birth.
To prevent these, nurse should immediately clean the perineal area to remove any stool while at the same time reassuring the women that the passage stool at this time is normal and expected event.
Routine use of an enema to empty rectum is considered to be harmful or ineffective and should be eliminated.