Hyperemesis Gravidarum by Dr Alka Mukherjee Dr Apurva Mukherjeealka mukherjee
Nausea and vomiting of pregnancy (NVP) are common during the first trimester of pregnancy, affecting 50 to 80% of pregnant women. A much smaller proportion (0.3-3%) of pregnant women encounter intractable vomiting, which may be complicated by dehydration, significant weight loss, and electrolyte disturbances necessitating hospital admission [1]. This condition is called hyperemesis gravidarum (HG). HG has a major effect on patients’ quality of life and is associated with adverse perinatal outcomes, including low birth weight, small for gestational age, and prematurity .Hyperemesis gravidarum is extreme, persistent nausea and vomiting during pregnancy. It can lead to dehydration, weight loss, and electrolyte imbalances. Morning sickness is mild nausea and vomiting that occurs in early pregnancy.
Most women have some nausea or vomiting (morning sickness), particularly during the first 3 months of pregnancy. The exact cause of nausea and vomiting during pregnancy is not known. However, it is believed to be caused by a rapidly rising blood level of a hormone called human chorionic gonadotropin (HCG). HCG is released by the placenta. Mild morning sickness is common. Hyperemesis gravidarium is less common and more severe.
Women with hyperemesis gravidarum have extreme nausea and vomiting during pregnancy. It can cause a weight loss of more than 5% of body weight. The condition can happen in any pregnancy, but is a little more likely if you are pregnant with twins (or more babies), or if you have a hydatidiform mole. Women are at higher risk for hyperemesis if they have had the problem in previous pregnancies or are prone to motion sickness.
Hyperemesis Gravidarum by Dr Alka Mukherjee Dr Apurva Mukherjeealka mukherjee
Nausea and vomiting of pregnancy (NVP) are common during the first trimester of pregnancy, affecting 50 to 80% of pregnant women. A much smaller proportion (0.3-3%) of pregnant women encounter intractable vomiting, which may be complicated by dehydration, significant weight loss, and electrolyte disturbances necessitating hospital admission [1]. This condition is called hyperemesis gravidarum (HG). HG has a major effect on patients’ quality of life and is associated with adverse perinatal outcomes, including low birth weight, small for gestational age, and prematurity .Hyperemesis gravidarum is extreme, persistent nausea and vomiting during pregnancy. It can lead to dehydration, weight loss, and electrolyte imbalances. Morning sickness is mild nausea and vomiting that occurs in early pregnancy.
Most women have some nausea or vomiting (morning sickness), particularly during the first 3 months of pregnancy. The exact cause of nausea and vomiting during pregnancy is not known. However, it is believed to be caused by a rapidly rising blood level of a hormone called human chorionic gonadotropin (HCG). HCG is released by the placenta. Mild morning sickness is common. Hyperemesis gravidarium is less common and more severe.
Women with hyperemesis gravidarum have extreme nausea and vomiting during pregnancy. It can cause a weight loss of more than 5% of body weight. The condition can happen in any pregnancy, but is a little more likely if you are pregnant with twins (or more babies), or if you have a hydatidiform mole. Women are at higher risk for hyperemesis if they have had the problem in previous pregnancies or are prone to motion sickness.
Please find the power point on Hyperemesis gravidarum and its managemen. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
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
Presented by:
Ahmad mukhtar
MD.,M.B.B.Ch., M.Sc Obstetrics and Gynecology Consultant and Lecturer of Obstetrics and Gynecology, Faculty of
MEDICINE, Zagazig University.
This presentation is about Hyperemesis Gravidarum. What is it and what are the causes. How you'll diagnose and differentiate it from other disorders. We'll learn about it's management as well as termination of pregnancy.
Please find the power point on Hyperemesis gravidarum and its managemen. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
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
Presented by:
Ahmad mukhtar
MD.,M.B.B.Ch., M.Sc Obstetrics and Gynecology Consultant and Lecturer of Obstetrics and Gynecology, Faculty of
MEDICINE, Zagazig University.
This presentation is about Hyperemesis Gravidarum. What is it and what are the causes. How you'll diagnose and differentiate it from other disorders. We'll learn about it's management as well as termination of pregnancy.
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.
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.
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
- 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
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
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.
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.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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
2. Definitions
>Morning sickness: is the nausea felt by about 50% of pregnant
women on getting up in the morning.
> Emesis gravidarum: Actual vomiting in the morning.
> These two conditions usually start between the 4th and 6th
weeks of pregnancy and improves or disappears about the 12
th week.
>Hyperemesis gravidarum: The vomiting is not confined to the
morning but it is repeated throughout the day until it affects
the general condition of the patient.
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3. Aetiology
1. Hormonal: high human chorionic gonadotrophin
(hCG) stimulates the chemoreceptor trigger zone
in the brain stem including the vomiting center.
This is the most accepted theory and proved by
the higher frequency in the conditions where the
hCG is high as in:-
a. early in pregnancy,
b. vesicular mole and
c. multiple pregnancy.
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4. Aetiology
2.Allergy: to the corpus luteum or the released
hormones.
3. Deficiency of:
a. adrenocortical hormone and /or,
b. vitamin B6 and B1
4.Nervous and psychological:
a.due to psychological rejection of an
unwanted pregnancy,
b. fear of pregnancy or labour so it is more
common in primigravidae.
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5. Pathological Changes:
These are the same as in prolonged
* Liver: small fatty infiltration.
* Kidney: fatty degeneration of the convoluted tubules.
* Heart: small subendocardial and subpericardial
haemorrhages.
* Brain: congestion and petechial haemorrhages in the
brain stem resembling that of Wernicke’s
encephalopathy.
• Eye: optic neuritis and retinal haemorrhage.
* Peripheral nerves: degeneration. starvation:
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6. Pathological Changes:
Blood:
• Hypovolaemia and haemoconcentration.
• Hyponatraemia, hypokalaemia and hypochloraemia.
• Increased blood urea.
• Hyperbilirubinaemia (due to liver damage).
• Acidosis.
Urine:
• Oliguria.
• Increased specific gravity.
• Decreased chloride.
• Albuminuria.
• Ketonuria.
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7. Diagnosis
Symptoms:
>The patient cannot retain anything in her stomach,
vomiting occurs through the day and night even
without eating.
>Thirst, constipation and oliguria.
>In severe cases, vomitus is bile and/ or blood stained.
> Finally, there is manifestations of Werniche’s
encephalopathy as drowsiness, nystagmus and loss of
vision then coma.
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8. Diagnosis
Signs:
Manifestations of starvation and dehydration: *
*Loss of weight.
* Sunken eyes.
* Dry tongue and inelastic skin.
* Pulse: rapid and weak.
* Blood pressure: low.
* Temperature: slight rise.
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9. Differential diagnosis
• Other causes of vomiting as:
* cholecystitis,
* appendicitis,
* pyelonephritis,
* gastroenteritis,
* gall bladder diseases,
* complicated ovarian tumours.
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11. Management
Intravenous fluids
* Oral feeding is prevented for 24-48 hours.
* Three litres of glucose 5% is given by rapid
infusion over 2-3 hours.
* Maintain intravenous glucose 5% and saline
therapy.
* When vomiting is controlled frequent gradual
smallcarbohydrate diets are started.
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12. Management
Drugs
* Adrenocortical preparations.
* Vit. B6 and Vit. B1.
* Antihistaminics that have antiemetic effect as
meclozinehydrochloride 25-50 mg twice daily. A
preparation contains both meclozine
hydrochloride + pyridoxine hydrochloride (vit. B6)
is of good benefit.
* Phenothiazine (chlorpromazine=largactil) 5-10 mg
three times daily has a tranquilliser and
antiemetic effect.
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13. Observation for:
* Vomiting: frequency, amount, colour and
contents.
* Vital signs: pulse, temperature and blood
pressure.
* Fluid: intake and output.
* Urine analysis: specific gravity, albumin, ketone
bodies,chloride and bile pigments.
* Blood: urea, electrolyte and liver function tests.
* Eye: examination of the fundus.
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