This document discusses hyperemesis gravidarum (HG), a severe form of nausea and vomiting during pregnancy. HG affects 0.3-3.6% of pregnant women and is one of the leading causes of hospitalization among pregnant women. It is defined as nausea and vomiting during early pregnancy when no other cause is identified. HG is thought to be associated with high levels of the hCG hormone and conditions with higher hCG like multiple pregnancies are associated with more severe HG. HG is diagnosed when a woman experiences severe, prolonged nausea and vomiting leading to weight loss of over 5% and dehydration. Treatment involves rehydration, electrolyte replacement, and antiemetic medications to prevent further complications.
PowerPoint presentation of emesis in pregnancy given at resident presentation, obstetrics and gynecology directorate, Komfo Anokye Teaching Hospital
risk factors, symptoms, management of severe vomiting with dehydration and weight loss in pregnancy
Placenta previa (pluh-SEN-tuh PREH-vee-uh) occurs when a baby's placenta partially or totally covers the mother's cervix — the outlet for the uterus. Placenta previa can cause severe bleeding during pregnancy and delivery. If you have placenta previa, you might bleed throughout your pregnancy and during your delivery
PowerPoint presentation of emesis in pregnancy given at resident presentation, obstetrics and gynecology directorate, Komfo Anokye Teaching Hospital
risk factors, symptoms, management of severe vomiting with dehydration and weight loss in pregnancy
Placenta previa (pluh-SEN-tuh PREH-vee-uh) occurs when a baby's placenta partially or totally covers the mother's cervix — the outlet for the uterus. Placenta previa can cause severe bleeding during pregnancy and delivery. If you have placenta previa, you might bleed throughout your pregnancy and during your delivery
Thyroid disease in_pregnancy
Presented by: Dr. Ahmad mukhtar
M.B.B.Ch., M.Sc Obstetrics and GynecologyAssistante lecturer of Obstetrics and Gynecology
Faculty of Medicine, Zagazig University
Thyroid disease in_pregnancy
Presented by: Dr. Ahmad mukhtar
M.B.B.Ch., M.Sc Obstetrics and GynecologyAssistante lecturer of Obstetrics and Gynecology
Faculty of Medicine, Zagazig University
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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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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
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
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
2. INTRODUCTION
IT AFFECTS UP TO 80% OF PREGNANT WOMEN &IS ONE OF THE
MOST COMMON INDICATIONS FOR HOSPITAL ADMISSION AMONG
PREGNANT WOMEN, WITH TYPICAL STAYS OF BETWEEN 3 AND 4
DAYS.
3. DEFINITION
• IT IS DEFINED AS THE SYMPTOM OF NAUSEA AND/OR VOMITING DURING
EARLY PREGNANCY WHERE THERE ARE NO OTHER CAUSES.
• IT AFFECTS ABOUT 0.3–3.6% OF PREGNANT WOMEN.
4. MECHANISM
• IT IS THOUGHT TO BE ASSOCIATED WITH RISING LEVELS OF BETA
HUMAN CHORIONIC GONADOTROPHIN (HCG) HORMONE, AND
CONDITIONS WITH HIGHER HCG LEVELS, SUCH AS
• TROPHOBLASTIC DISEASE AND MULTIPLE PREGNANCY, HAVE
BEEN ASSOCIATED WITH INCREASED SEVERITY OF NVP.
5. HOW IS HG DIAGNOSED?
• HG IS CHARACTERISED BY SEVERE, PROTRACTED NAUSEA AND
VOMITING ASSOCIATED WITH WEIGHT LOSS OF MORE THAN 5%
OF PREPREGNANCY WEIGHT, DEHYDRATION AND ELECTROLYTE
IMBALANCES.
• ONSET OF NVP IS IN THE FIRST TRIMESTER AND IF THE INITIAL
ONSET IS AFTER 10+6 WEEKS OF GESTATION, OTHER CAUSES
NEED TO BE CONSIDERED.
• IT TYPICALLY STARTS BETWEEN THE FOURTH AND SEVENTH
WEEKS OF GESTATION, PEAKS IN APPROXIMATELY THE NINTH
WEEK AND RESOLVES BY THE 20TH WEEK IN 90% OF WOMEN.
6. Morning Sickness: Hyperemesis Gravidarum:
Nausea sometimes accompanied by
vomiting
Nausea accompanied by severe vomiting
Nausea that subsides at 12 weeks or
soon after
Nausea that does not subside
Vomiting that does not cause severe
dehydration
Vomiting that causes severe dehydration
Vomiting that allows you to keep some
food down
Vomiting that does not allow you to keep
any food down
7. •HISTORY
• ● PREVIOUS HISTORY OF NVP/HG
• ● QUANTIFY SEVERITY USING PUQE SCORE: NAUSEA,
VOMITING, HYPERSALIVATION, SPITTING, LOSS OF WEIGHT,
• INABILITY TO TOLERATE FOOD AND FLUIDS, EFFECT ON
QUALITY OF LIFE
• ● HISTORY TO EXCLUDE OTHER CAUSES:
• – ABDOMINAL PAIN URINARY SYMPTOMS
• – INFECTION DRUG HISTORY
• – CHRONIC HELICOBACTER PYLORI INFECTION
8. •EXAMINATION
• ● TEMPERATURE
• ● PULSE
• ● BLOOD PRESSURE
• ● OXYGEN SATURATIONS
• ● RESPIRATORY RATE
• ● ABDOMINAL EXAMINATION
• ● WEIGHT
• ● SIGNS OF DEHYDRATION
• ● SIGNS OF MUSCLE WASTING
• ● OTHER EXAMINATION AS GUIDED BY HISTORY
9. •INVESTIGATION
• ● URINE DIPSTICK: QUANTIFY KETONURIA AS 1+ KETONES OR
MORE
• ● UREA AND ELECTROLYTES:
• – HYPOKALAEMIA/HYPERKALAEMIA
• – HYPONATRAEMIA
• – DEHYDRATION
• – RENAL DISEASE
• ● FULL BLOOD COUNT
• – HAEMATOCRIT
• ● BLOOD GLUCOSE MONITORING
10. • ● ULTRASOUND SCAN:
• – CONFIRM VIABLE INTRAUTERINE PREGNANCY
• – EXCLUDE MULTIPLE PREGNANCY AND
TROPHOBLASTIC DISEASE
• ● IN REFRACTORY CASES OR HISTORY OF PREVIOUS
ADMISSIONS, CHECK:
• – TFTS: HYPOTHYROID/HYPERTHYROID
• – LFTS: EXCLUDE OTHER LIVER DISEASE SUCH AS
HEPATITIS OR GALLSTONES, MONITOR MALNUTRITION
• – CALCIUM AND PHOSPHATE
• – AMYLASE: EXCLUDE PANCREATITIS
• – ABG: EXCLUDE METABOLIC DISTURBANCES TO
MONITOR SEVERITY
12. MANAGEMENT
• WOMEN WITH MILD NVP SHOULD BE MANAGED IN THE
COMMUNITY WITH ANTIEMETICS.
• AMBULATORY DAYCARE MANAGEMENT SHOULD BE USED FOR
SUITABLE PATIENTS WHEN COMMUNITY/PRIMARY CARE
MEASURES HAVE FAILED AND WHERE THE PUQE SCORE IS LESS
THAN 13.
13. • INPATIENT MANAGEMENT SHOULD BE CONSIDERED IF THERE IS
AT LEAST ONE OF THE FOLLOWING:
• ● CONTINUED NAUSEA AND VOMITING AND INABILITY TO KEEP
DOWN ORAL ANTIEMETICS
• ● CONTINUED NAUSEA AND VOMITING ASSOCIATED WITH
KETONURIA AND/OR WEIGHT LOSS (GREATER THAN 5% OF BODY
WEIGHT), DESPITE ORAL ANTIEMETICS
• ● CONFIRMED OR SUSPECTED COMORBIDITY (SUCH AS URINARY
TRACT INFECTION AND INABILITY TO TOLERATE ORAL
ANTIBIOTICS).
14. FIRST-LINE ANTIEMETICS SUCH AS ANTIHISTAMINES (H1
RECEPTOR ANTAGONISTS) AND PHENOTHIAZINES ARE SAFE &
EFFECTIVE AND THEY SHOULD BE PRESCRIBED.
• COMBINATIONS OF DIFFERENT DRUGS SHOULD BE USED IN
WOMEN WHO DO NOT RESPOND TO A SINGLE ANTIEMETIC.
• FOR WOMEN WITH PERSISTENT OR SEVERE HG, THE
PARENTERAL OR RECTAL ROUTE MAY BE NECESSARY AND
MORE EFFECTIVE THAN AN ORAL REGIMEN.
• WOMEN SHOULD BE ASKED ABOUT PREVIOUS ADVERSE
REACTIONS TO ANTIEMETIC THERAPIES. DRUG-INDUCED
• EXTRAPYRAMIDAL SYMPTOMS AND OCULOGYRIC CRISES CAN
OCCUR WITH THE USE OF PHENOTHIAZINES AND
METOCLOPRAMIDE. IF THIS OCCURS, THERE SHOULD BE
PROMPT CESSATION OF THE MEDICATIONS.
15. • METOCLOPRAMIDE IS SAFE AND EFFECTIVE, BUT BECAUSE OF
THE RISK OF EXTRAPYRAMIDAL EFFECTS IT SHOULD BE USED
AS SECOND-LINE THERAPY.
• THERE IS EVIDENCE THAT ONDANSETRON IS SAFE AND
EFFECTIVE, BUT BECAUSE DATA ARE LIMITED IT SHOULD BE
USED AS SECOND-LINE THERAPY.
• CORTICOSTEROIDS SHOULD BE RESERVED FOR CASES WHERE
STANDARD THERAPIES HAVE FAILED.
• DIAZEPAM IS NOT RECOMMENDED FOR THE MANAGEMENT.
16. MONITORING
• UREA AND SERUM ELECTROLYTE LEVELS SHOULD BE CHECKED DAILY IN
WOMEN REQUIRING INTRAVENOUS FLUIDS.
• HISTAMINE H2 RECEPTOR ANTAGONISTS OR PROTON PUMP INHIBITORS MAY
BE USED FOR WOMEN DEVELOPING GASTRO-OESOPHAGEAL REFLUX
DISEASE, OESOPHAGITIS OR GASTRITIS.
• THIAMINE SUPPLEMENTATION (EITHER ORAL OR INTRAVENOUS) SHOULD BE
GIVEN TO ALL WOMEN ADMITTED WITH PROLONGED VOMITING, ESPECIALLY
BEFORE ADMINISTRATION OF DEXTROSE OR PARENTERAL NUTRITION.
• WOMEN ADMITTED WITH HG SHOULD BE OFFERED THROMBOPROPHYLAXIS
WITH LOW-MOLECULAR-WEIGHT HEPARIN
• WOMEN WITH PREVIOUS OR CURRENT NVP OR HG SHOULD CONSIDER
AVOIDING IRON-CONTAINING PREPARATIONS
17.
18. FOLLOW UP
• WOMEN WITH NVP AND HG SHOULD HAVE AN INDIVIDUALISED
MANAGEMENT PLAN IN PLACE WHEN THEY ARE DISCHARGED
FROM HOSPITAL.
• WOMEN WITH SEVERE NVP OR HG WHO HAVE CONTINUED
SYMPTOMS INTO THE LATE SECOND OR THE THIRD TRIMESTER
SHOULD BE OFFERED SERIAL SCANS TO MONITOR FETAL
GROWTH.