The document discusses the hormonal regulation of pregnancy. It describes the key hormones produced by the placenta and fetal adrenal gland, including human chorionic gonadotropin, human placental lactogen, progesterone, and estrogen. It explains how these hormones facilitate adaptations in various maternal systems and are responsible for the physiological symptoms of pregnancy. The document also outlines the hormones involved in labor and lactation, including oxytocin and prolactin.
Fertilization of the ovum prevents the regression of the corpus luteum. Instead, the corpus luteum enlarges, stimulated by the glycoprotein hormone, hCG, produced by the trophoblast (the developing placenta).
Fertilization of the ovum prevents the regression of the corpus luteum. Instead, the corpus luteum enlarges, stimulated by the glycoprotein hormone, hCG, produced by the trophoblast (the developing placenta).
Control mechanism of Female Reproductionsunitafeme
The menstrual cycle is the scientific term for the physiological changes that occur in fertile women for the purpose of sexual reproduction.The menstrual cycle is controlled by the endocrine system
Since the first formal description of LPD in 1949 as a possible cause of infertility and recurrent miscarriage by Jones. Innumerable investigations have been undertaken in an effort to verify its existence or to characterize its pathophysiology, diagnosis, and treatment. The consensus of the literature is that LPD does exist and that its cause is multifactorial like abnormal folliculogenesis, inadequate LH surge,inadequate secretion of progesterone by the corpus luteum, aberrant end-organ response by the endometrium.
Control mechanism of Female Reproductionsunitafeme
The menstrual cycle is the scientific term for the physiological changes that occur in fertile women for the purpose of sexual reproduction.The menstrual cycle is controlled by the endocrine system
Since the first formal description of LPD in 1949 as a possible cause of infertility and recurrent miscarriage by Jones. Innumerable investigations have been undertaken in an effort to verify its existence or to characterize its pathophysiology, diagnosis, and treatment. The consensus of the literature is that LPD does exist and that its cause is multifactorial like abnormal folliculogenesis, inadequate LH surge,inadequate secretion of progesterone by the corpus luteum, aberrant end-organ response by the endometrium.
Assessment and management of pregnancy (antenatal) ppt.pptxMeenakshiJohn1
In this assessment and management describe about the reproductive health ,disorder of reproductive health and about pre conception ,genetic counseling and the physiological changes in the reproductive system of pregnant women .briefly knowledge about hematological changes and also the changes of cardiovascular system during pregnancy . the important role of endocrine gland during pregnancy .thyroid and the important role of a hormones and their maintenance .and their minor ailments in pregnancy or discomforts of pregnancy .sign and symptoms of pregnancy
physiological changes during pregnancy
effect of pregnancy on physiological functions during pregnancy
cardiovascular, respiratory and hormonal changes
Shifa Riaz
gynecology
obstetrics
females
Biochemical changes in pregnancy, Physiological changes in pregnancy, maternal and fetal health assessment, assessment of complications in pregnancy, hormonal changes and physiological evaluations in pregnancy
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.
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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!
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
3. Learning objectives
8.
Endocrine change
in mother
10. Changes in
maternal
circulation
12.Consequences
of pregnancy on
respiration
• Physiological
symptoms (13)
• How pregnancy
is detected (14)
4. A trigger !
A 26 years old G1P0 at 35
weeks of pregnancy came to
Antenatal clinic with the
complaint of sudden blackout
while getting up from the
couch
she has noticed increasing
spell of breathing difficulty
and feels her heart moves
faster for no obvious reason .
she feels burning sensation
below the ribs and she has
bowel motion every two days .
A clinical
scenario
Her pulse is 90 /m
BP : 100/70
Respiration rate : 24/m
Mild pedal edema
Cardiac sound : S1, S2 normal
Chest : normal to auscultation
How do you plan to manage
advise this lady ?
Your
response
?
5. Outliner
Hormones of the placenta
fetal adrenal gland
Changes in the various systems
Hormones of the labor and
lactation
14. Protein hormones
• Human chorionic gonadotropin
• Human placental lactogen
• Growth Factors
• Early pregnancy factor (EPF)
• Pregnancy specific B 1 Glycoprotein
• Pregnancy associated plasma protein (PAPPA)
15. Human Chorionic Gonadotropin
• Glycoprotein
• Molecular weight : 36K-40K Dalton
• Hormone Nonspecific unit : alpha (92amino A)
• Hormone specific unit : Beta (145 amino A)
16. HCG : Function
Stimulus for
• Corpus luteum
• Leydig cells
• Immuno suppression
• Adrenal / placental steroidogenesis
• Maternal thyroid
• Relaxin from CL
18. Human Placental Lactogen
• HC somato mammotropin
• Syn cytiotrophoblast
• similar to GH , Prolactin
• 3rd week
• 5 to 25 micg/ml ( 36 wks)
• Plasma conc placental mass
19.
20. Function of HPL
• Antagonize insulin
• Maternal lipolysis
• Angiogesis : fetal vasculature
• growth of breast lactation
26. Estrogen
What placenta does not have ?
17,20-lyase (CYP17)
C21 C19
• helped fetal adrenal gland .
What placenta has ?
27. Function
Progesterone
• Maintenance of pregnancy
• uterine growth
•
• endometrim decidua
• myometrial contraction
• Development of breast
• Lobulo alveolar system
Estrogen
• Maintenance of pregnancy
• Hypertrophy
hyperplasia
• accomodation
blood flow
Development of breast
• Hypertrophy
proliferation of duct
28. Function
Progesteron
• quiescence
• lysosomal membranes
• prostaglandin synthesis
• Immuno modulatory
Estrogen
• Sensitize myometrium to
oxytocin and prostaglandin
• Ripens the cervix
29. Both
• adaptation of the maternal organs
increasing demand growing fetus
• activity of gonadotropin –gonadal axis
30. Fetal adrenal Gland
• largest
• unique fetal zone. (85%)
100 to 200 mg/d
30 to 40 mg/day (A)
55. Hormones of the lactation
• ejection
•oxytocin
• maintenance
•Prolactin
• synthesis and
secretion
•prolactin
•preparation
•Estrogen : duct
formation
Mammogenesis lactogenesis
galactokinesisgalactopoiesis
56. Answer to our case
The reason for
sudden black
out
The reason for
breathing
difficulty
The reason for
heart burn and
constipation
57. Summary
• Hormones liberated after conception are
responsible for establishment and
maintenance of a successful pregnancy and
lactation.
• These hormones regulate and help in
adaptations of various maternal systems .
• It may produce certain vexing symptoms of
pregnancy, which is physiological and
disappears immediately after the delivery .
58. A teaser for the day !
What is the reason for
increasing cardiac
output in later half of
the pregnancy ?
Circulatory volume
Decreased PRMaternal heart rate
Stroke volume
Ovulation : LH surge
Preovulatory rise of 17 alpha OH progesterone
Positive feed back of estrogen
Combined FSH rise and LH surge
Completion of reduction division of oocyte
Lutenisation of granulosa cell
Synthesis of progesteron and prostaglandin
CL Secretes about 40 mg of progesterone per day
Syncytiotrophoblast after implantation secretes HCG and HPL
Maintains the growth and function of CL
Chemically and functionally similar to LH
A subunit is similar to LH , FSH and TSH
B subunit is unique to HCG
Placental GnRH has a control over HCG
Peak levels reach about 100,000 mIU/mL (D60-80 )
beginning of 10 to 12 wks GA, hCG begins to decline
nadir is reached by about 20 weeks
Lower level in ectopic pregnancy / abortion
Higher level in hydratidiform mole , Rh isoimmunisation
Following delivery , not detectable after 24 hours
Dehydroepiandrosterone sulfate (DHEA-S), secreted in
fetal adrenal glands, is converted to 16 -hydroxydehydroepiandrosterone sulfate (16 OH DHEA-S) in the fetal liver.
These steroids, DHEA-S and 16 OHDHEA-S, are converted in the placenta to estrogens, viz., 17 -estradiol (E2) and estriol (E3).
Near term, half of E2 is derived from fetal adrenal DHEA-S and half from maternal DHEA-S.
90 percent of E3 in the placenta arises from fetal 16 OHDHEA-S and only 10 percent from all other sources
can synthesize cholesterol from two-carbon fragments,
All enzymes involved in cholesterol biosynthesis are elevated
lipoproteins are used as a source of cholesterol