This document summarizes HIV/AIDS during pregnancy. It discusses how HIV causes AIDS by depleting CD4 cells. Around 25-30% of people with HIV worldwide are women aged 20-49. The document outlines how HIV is transmitted from mother to child, mainly during labor and delivery. It recommends offering HIV testing to all pregnant women and treating HIV-positive mothers with antiretroviral therapy to reduce the risk of transmission to less than 2%. Safety measures during pregnancy, delivery and postpartum are also discussed.
When fetal head is delivered, but shoulders are stuck and cannot be delivered it is known as shoulder dystocia.
The anterior shoulder becomes trapped behind on the symphysis pubis, whilst the posterior shoulder may be in the hollow of the sacrum or high above the sacral promontory.
Please find the power point on HIV and its managment. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Vertical transmission is major contributor- HIV among children
No intervention – as high as 45%
With interventions – as low as less than 5%
Minimal manipulation
NVD vs. C-section
Anti retroviral prophylaxis vs. anti retroviral therapy
Exclusive breastfeeding vs. exclusive replacement feeding
Follow-up and care.
When fetal head is delivered, but shoulders are stuck and cannot be delivered it is known as shoulder dystocia.
The anterior shoulder becomes trapped behind on the symphysis pubis, whilst the posterior shoulder may be in the hollow of the sacrum or high above the sacral promontory.
Please find the power point on HIV and its managment. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Vertical transmission is major contributor- HIV among children
No intervention – as high as 45%
With interventions – as low as less than 5%
Minimal manipulation
NVD vs. C-section
Anti retroviral prophylaxis vs. anti retroviral therapy
Exclusive breastfeeding vs. exclusive replacement feeding
Follow-up and care.
Tuberculosis in prenancy by dr alka mukherjee dr apurva mukherjee nagpur ms i...alka mukherjee
Prevention of Tuberculosis
The BCG vaccine has been incorporated into the National immunization policy of many countries, especially the high burden countries, thereby conferring active immunity from childhood. Nonimmune women travelling to tuberculosis endemic countries should also be vaccinated. It must, however, be noted that the vaccine is contraindicated in pregnancy [72].
The prevention, however, goes beyond this as it is essentially a disease of poverty. Improved living condition is, therefore, encouraged with good ventilation, while overcrowding should be avoided. Improvement in nutritional status is another important aspect of the prevention.
Pregnant women living with HIV are at higher risk for TB, which can adversely influence maternal and perinatal outcomes [73]. As much as 1.1 million people were diagnosed with the co-infection in 2009 alone [2]. Primary prevention of HIV/AIDS is, therefore, another major step in the prevention of tuberculosis in pregnancy. Screening of all pregnant women living with HIV for active tuberculosis is recommended even in the absence of overt clinical signs of the disease.
Isoniazid preventive therapy (IPT) is another innovation of the World Health Organisation that is aimed at reducing the infection in HIV positive pregnant women based on evidence and experience and it has been concluded that pregnancy should not be a contraindication to receiving IPT. However, patient's individualisation and rational clinical judgement is required for decisions such as the best time to provide IPT to pregnant women
AIDS Stands for Acquired Immune Deficiency Syndrome.
In Bangladesh the First case of HIV was detected in 1989. According to the recent UNAIDS report 2017, around 12,000 people are living with HIV infection of them 7,500 are male and aged 15 or above.
Incubation period is 6 months to 5 years or more.
HIV: HIV stands for human immunodeficiency virus. It harms immune system by destroying a type of white blood cell that help our body fight infection.
AIDS: AIDS stands for Acquired Immuno deficiency syndrome. It is final stage of infection with HIV. It happens when the body’s immuno system is badly damaged because of the virus.
HIV in Pregnancy: HIV in pregnancy is the presence of an HIV\AIDS infection in a woman while she is pregnant.
Causes:
HIV Virus.
Sexual transmission.
Blood transfusion.
Risk factors:
Sexually transmitted diseases (STD).
People who inject drug with shared needles.
Multiple partners.
Blood transfusion.
low status women.
It is a presentation on HIV\AIDS in Pregnancy 2023
Influenza, zika, ebola in pregnancy by dr alka mukherjee nagpur m s indiaalka mukherjee
Viral infections in pregnancy are major causes of maternal and fetal morbidity and mortality. Infections can develop in the neonate transplacentally, perinatally (from vaginal secretions or blood), or postnatally (from breast milk or other sources). The clinical manifestations of neonatal infections vary depending on the viral agent and gestational age at exposure. The risk of infection is usually inversely related to gestational age at acquisition, some resulting in a congenital malformation syndrome.
Infections known to produce congenital defects have been described with the acronym TORCH (Toxoplasma, others, rubella, cytomegalovirus [CMV], herpes). The "others" category has rapidly expanded to include several viruses known to cause neonatal disease
Pregnant women, their fetuses, and infants are at a high risk of exposure to infectious diseases, especially in low-income regions of the world where vaccine-preventable diseases are prevalent. Vaccines administered during pregnancy can protect not only pregnant women against infection-related morbidity and mortality, but also their fetuses and infants against preterm delivery, perinatal death, and disability. viral infections and human rights.
Pregnant women, their fetuses, and infants are at a high risk of exposure to infectious diseases, especially in the resource-poor and low-income regions of the world where vaccine-preventable diseases are prevalent. Because of this, vaccines administered during pregnancy offer the potential to protect not only pregnant women against infection-related morbidity and mortality, but also their fetuses and infants against preterm delivery, perinatal death, and disability. The potential benefits of providing immunization to pregnant women and their infants to protect against infection are not a novel concept—even during the early development of vaccines, their usage during pregnancy was considered potentially beneficial.
These slides contain detailed description of HIV in children including : Introduction, Definition, HIV structure, Incidence, Impact of HIV on infant and child survival, Mode of transmission - Vertical transmission and horizontal transmission, Pathophysiology, Clinical features, Laboratory investigations, Management, Prevention, Nursing management, Nursing diagnosis.
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.
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.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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
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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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
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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.
1. HIV / AIDS DURING
PREGNANCY
PRESENTED BY:
LAMNUNNEM HAOKIP
MSC (N) 2ND YEAR
SNSR, SU
UNDER THE SUPERVISION
OF
DR. SHANTI IDA
PROF.CUM HOD (OBG)
SNSR, SU
2. INTRODUCTION
• Human Immunodeficiency Virus (HIV)
causes an incurable infection that leads
ultimately to a terminal disease called
Acquired Immunodeficiency Syndrome
(AIDS).
• Worldwide 25 – 30% of infected patients
are women and 90% of them are 20 – 49
years of age.
3. DEFINITION
• Human Immunodeficiency Virus (HIV) : It
belongs to retrovirus family which is the
causative agent of Acquired
Immunodeficiency Syndrome (AIDS).
• Acquired Immunodeficiency Syndrome
(AIDS): A disease in which there is a severe
loss of the body's cellular immunity, greatly
lowering the resistance to infection and
malignancy.
4. IMMUNOPATHOGENESIS
• The target for HIV is the CD4 receptor molecule.
• Cells within the immune system that have this
molecule are : CD4+ T lymphocytes, monocytes,
macrophages and other antigen presenting cells
like fibroblasts, neurons, renal, hepatic and
intestinal cells.
• Following infection, there is profound cellular
immunodeficiency as the CD4+ are progressively
depleted by cytopathic effects of HIV.
5. Immunological markers that are used to
determine the progression of the disease are as
follows:
• CD4 T lymphocytes count – patients with count
from 200 – 300 cells/mm3 are likely to have HIV
related symptoms and count <200 cells/mm3 is
taken into AIDS defining criteria.
• Measurement of HIV RNA levels by RT-PCR and
the bDNA assays.
6. MODE OF TRANSMISSION
• Multiple partners, prostitution.
• IV drug abusers
• Multiple transfusion of blood and blood
products
• Parent to child
7. CLINICAL PRESENTATION
Acute infection syndrome is characterized
by:
• Fever
• Skin rash
• Arthralgia
• Lymphadenopathy
• Diarrhoea - This is called seroconversion
illness. It lasts less than 2-3 weeks and
resolves spontaneously.
8. AIDS related complex refers to subjects
having nonspecific clinical features like:
• Weight loss
• Fever, diarrhoea, herpes simplex, oral or
recurrent genital candidiasis, oral or genital
ulcers.
• Pelvic Inflammatory Disease
• Tubo-ovarian abscess.
• Thrombocytopenia.
9. PARENT TO CHILD TRANSMISSION
• Vertical transmission to the neonates is
about 14 – 25%.
• Trans-placental transmission occurs 20%
before 36 weeks and over 80% of
transmission around the time of labour
and delivery.
• Vertical transmission is more in cases
with pre-term birth and with prolonged
membrane rupture.
10. • Risks of vertical transmission are directly
related to maternal viral load and
inversely to maternal immune status.
• Maternal Antiretroviral Therapy reduces
the risk of vertical transmission by 70%.
• The maximum risk of transmission form
parent to child is the peri-partum period
and intra-partum period.
11. PREVENTION OF PARENT TO CHILD
TRANSMISSION :
Guidelines by National AIDS Control
Organization (NACO):
• HIV testing is recommended in all pregnant
women which is opt-out approach.
• Antiretroviral therapy is recommended for all
HIV positive women irrespective of their CD4
counts.
• Vaginal delivery is recommended, Caesarean
section is not the only option.
12. INTERVENTION RISK OF HIV
TRANSMISSION
FROM MOTHER
TO CHILD
No intervention and
continue breastfeeding
30 – 45%
No ART and stop
breastfeeding
20 – 25%
ART and continue
breastfeeding
2%
ART and no
breastfeeding
1%
13. PROPHYLAXIS ON
ANTIRETROVIRAL THERAPY(ART)
• Initiate antiretroviral therapy in pregnancy as
soon as diagnosed with HIV positive. Once
started, it should be life-long.
Starting ART for the first time: Triple drug
regime:
• Tenofovir – 300 mg
• Lamivudine – 300 mg
• Efavirenz – 600 mg (considered safe in
pregnancy in all the trimester by world health
organization).
14.
15.
16. Women already on Antiretroviral Therapy
• If the mother is already on ART, she should
continue the regime.
Recommendations for delivery
• Vaginal delivery
• Caesarean section for obstetric indications.
• Minimize the vaginal examination
• Avoid early rupture of membrane.
• Avoid prolonged labour (Oxytocin can be used).
.
17. • Avoid routine episiotomy.
• Avoid unnecessary instrumentation
• During post-partum, methergine is
avoided because ART drugs and
methergine potentiates increase risk of
hypertension.
• According to world health organization,
there is no rush in early cord clamping.
18. Recommendations for Infant Prophylaxis
• After birth the infant should also get ART
prophylaxis irrespective of the mode of feeding
of the infant (breastfed and replacement fed
babies).
• Mother who has taken ART more than 4 weeks
during pregnancy, the infant should be given
Syrup Nevirapine for 6 weeks after delivery /
birth.
19.
20. • Mother has taken ART less than 4 weeks
during pregnancy, the infant should be
given Syrup Nevirapine for at least 12
weeks.
• For a mother who took Nevirapine in the
past or previous pregnancy, for the infant
Syrup Zidovudine.
21. STANDARD SAFETY MEASURES
Prenatal Care:
• Screening should be offered voluntarily.
• Counselling about the risks of HIV
transmission from parent to child.
• Tuberculin test should be test to find out
any associated factors which can leads to
HIV/AIDS.
22. Intra-partum Period
• Avoid instrumentations during labour.
• Careful handling of fluids of the mother.
• Use of personal protective equipment.
Post-partum Period
• Counsel regarding the breastfeeding and
help to informed choice.
• Keeping the perineal area clean with
antiseptic solutions to prevent infections
23. The followings are the safety measures to prevent form
transmission of HIV/AIDS from one person to another:
• HIV testing and linkage to care, HIV medications and
Access to condoms
• Prevention programs for people with HIV and their
partners
• Prevention programs for people at high risk for HIV
infection
• Substance abuse treatment and access to sterile syringes
• Sexually Transmitted Infections screening and treatment.
• Use of personal protective equipments.
25. BIBLIOGRAPHY / REFERENCE
• DC Dutta’s. Hiralal Konar. Textbook of
Obstetrics. 8th Edition. Jaypee The Health
Sciences Publishers. Page no. 350 – 353.
• Anamma Jacob. A cComprehensive
Textbook of Midwifery and Gynaecological
Nursing. Fourth Edition. Jaypee The Health
Sciences Publishers. Page no. 321 – 323.
• DC Dutta’s Hiralal Konar. Textbook of
Gynaecology. 7th Edition. Jaypee the health
sciences publishers. Page no.126 – 128.
• Park K. Park’s Textbook of Preventive and
Social Medicine, twenty fifth edition.
Banarsidas Bhanot Publishers; page no.
310 – 8.
• https://youtu.be/xIOqLQGQthQ